Somatic symptom disorder (SSD) is a novel construct, first presented in the DSM-5. It has two criteria: distressing or impairing bodily symptoms and excessive or disproportionate thoughts, feelings, or behaviors directed toward those symptoms. The criteria must be applied critically to make sense logically and clinically. The framework does not suggest any causal relationship between the elements. SSD uses a different formulation than in previous constructs, with no requirement that symptoms be medically unexplained. Little research has been conducted about SSD, and it is inappropriate to draw conclusions from similar diagnoses. Therefore, almost nothing is known about epidemiology, natural history, and treatment response in SSD. Health anxiety disorder is similar to SSD, but without significant somatic symptoms. Conversion disorder and factitious disorder entail more specific findings than does SSD. Providers should carefully apply diagnostic criteria for SSD, focus on the individual’s distress, and consider how this diagnosis influences the provider-patient relationship. Future research will refine the understanding of the condition and therapeutic approaches to it.
This review contains 1 figure, 5 tables, and 39 references.
Key words: behaviors, conversion disorder, disproportionate, excessive, factitious disorder, feelings, health anxiety, somatic symptom disorder, somatization, thoughts
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