A 30-year-old man presents with multiple ER visits for diverse non-specific symptoms (chest pain, abdominal pain, headache), extensive investigations yielding no pathology, and he visits three different physicians simultaneously. He denies any connection between symptoms and his recent job loss. The DSM-5 diagnosis is:
- A Illness anxiety disorder
- B Factitious disorder
- C Somatic symptom disorder ✓
- D Conversion disorder
Explanation
Somatic symptom disorder (DSM-5) requires one or more distressing somatic symptoms plus disproportionate/persistent thoughts, feelings, or behaviours related to those symptoms (e.g., excessive health-related anxiety, disproportionate time devoted to symptoms). The diagnosis does NOT require absence of medical disease — symptoms may be medically explained or unexplained. Illness anxiety disorder (formerly health anxiety/hypochondriasis) involves minimal somatic symptoms with excessive preoccupation of having a disease. Factitious disorder involves intentional symptom production. Conversion disorder involves neurological symptoms without organic basis.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.