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family medicine|Psychiatric and Psychologic|somatic symptom disorder

Somatic Symptom Disorder

Last Updated September 2023 | This article was created by editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

What is somatic symptom and related disorders?

Somatic symptom and related disorders is the name for a group of conditions in which the physical pain and symptoms a person feels are related to psychological factors. Such pain and symptoms result in excessive thoughts, feelings and behaviors and can interfere with a person’s ability to function and maintain relationships. These symptoms can’t be traced to a specific physical cause. In people who have a somatic symptom and related disorders, medical test results are either normal or don’t explain the person’s symptoms.

People who have this disorder may have several medical evaluations and tests to be sure that they don’t have another illness. They often become very worried about their health because they don’t know what’s causing their health problems. Their symptoms are similar to the symptoms of other illnesses and may last for several years. People who have a somatoform disorder are not faking their symptoms. The pain that they feel is real.

Symptoms of somatic symptom and related disorders

There are several types of somatic symptom and related disorders.

Somatization disorder usually involves pain and severe neurological symptoms (such as headache, fatigue). Other symptoms include:

  • Digestive symptoms (such as nausea, vomiting, abdominal pain, constipation, and diarrhea)
  • Sexual symptoms (such as pain during sexual activity, loss of sexual desire, and extremely painful periods in women)

Hypochondriasis occurs when a person believes that normal body functions (such as a grumbling stomach) or minor symptoms (such as a common headache) are symptoms of a very serious disorder. To a person who has hypochondriasis, a grumbling stomach may mean stomach cancer. A headache may mean a brain tumor.

Body dysmorphic disorder occurs when a person becomes obsessed with a flaw in their physical appearance. The flaw is either a minor flaw or a flaw that doesn’t exist. They constantly worry about the perceived flaw, which can be any part of the body. Common concerns for people who have body dysmorphic disorder include:

  • Wrinkles
  • Hair loss
  • Weight gain
  • Size and shape of feature like the eyes, nose, and breasts

Conversion disorder is when physical symptoms that are similar to a neurological disorder develop even though no neurological disorder is actually present. Common symptoms include:

  • Paralysis of an arm or leg
  • Vision loss
  • Hearing loss
  • Seizure

Stress may make the symptoms worse.

What causes somatic symptom and related disorders?

No one knows exactly why symptoms of somatic symptom and related disorders appear. In some cases, there may be a problem with the nerve impulses that send signals of pain, pressure, and other unpleasant sensations to the brain. We do know that the pain and problems caused by somatic symptom and related disorders are real. They are not imagined.

Like many medical problems, somatic symptom and related disorders often run in families. They also tend to come and go over time.

How is somatic symptom and related disorders diagnosed?

Somatic symptom and related disorders can be difficult to diagnose. Your doctor will do a physical exam and possibly order tests. If tests show that you aren’t sick, your doctor may refer you to a mental health provider. In general, your doctor will evaluate whether you are experiencing:

  • One or more physical symptoms that are concerning or cause disruption in daily life
  • Excessive thoughts, feelings or behaviors tied to the physical symptoms or health concerns with at least one of the following:
    • Ongoing thoughts that are larger than the seriousness of symptoms
    • Ongoing anxiety about health or symptoms
    • Excessive time and energy spent on the symptoms or health concerns
  • At least one symptom that is constantly present, although there may be different symptoms and symptoms may come and go

People with somatic symptom disorder typically see their primary care physician rather than seek counseling or mental health care. This may be due to the fact that people experiencing this disorder can’t accept a mental health diagnosis. They may continue to be fearful and worried even when they are shown evidence that they do not have a serious condition. Some people have only pain as their dominant symptom. Somatic symptom disorder usually begins by age 30.

Can somatic symptom and related disorders be prevented or avoided?

There is no known way to prevent somatic symptom and related disorders.

Somatic symptom and related disorder treatment

Although there is no known cure for somatoform disorders, they can be managed. Treatment focuses on helping the person who has the disorder to live as much of a normal life as possible. Even with treatment, they may still have some pain or other symptoms. Fortunately, a somatoform disorder will not shorten a person’s life.

Your doctor may be able to prescribe medicine for some of your symptoms. They may prescribe an antidepressant or anti-anxiety medicine to treat depressive and anxiety disorders, In many cases you will not need medicine for physical symptoms.

Living with somatic symptom and related disorders

Living with somatic symptom and related disorders can be hard. You may feel as though no one believes that you are really sick. You may not understand why this is happening to you. You may become frustrated with your body. Work with you doctor to manage your symptoms.

Seeing your doctor for regular checkups is the most important part of your treatment. Your doctor will tell you how often they need to see you. You may feel frustrated if your symptoms continue but remember that somatoform disorders can be very difficult to treat. Your doctor will do his or her best to help you maintain your health.

Questions to ask your doctor

  • If I have a somatic symptom and related disorder, are my symptoms all in my head?
  • What is the likely cause of my disorder?
  • What is the best treatment option? Do I need therapy? Medicine?
  • Will lifestyle changes, such as learning how to manage stress, help relieve my symptoms?
  • How often do I need to visit for check-ups?


American Psychiatric Association: What is Somatic Symptom Disorder
National Institutes of Health, MedlinePlus: Somatic Symptom Disorder

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