A 40-year-old woman has been to 8 physicians over 2 years with complaints of fatigue, headaches, abdominal pain, and palpitations. All investigations are normal. She is excessively preoccupied and distressed about these symptoms and finds them disabling. She does NOT believe she has a serious disease (no health anxiety). According to DSM-5, the MOST appropriate diagnosis is:

• A Illness Anxiety Disorder
• B Conversion Disorder
• C Factitious Disorder
• D Somatic Symptom Disorder ✓

Explanation

DSM-5 reorganized this area: Somatic Symptom Disorder (SSD) requires (1) one or more somatic symptoms causing distress/functional disruption, and (2) excessive thoughts, feelings, or behaviors related to those symptoms (disproportionate concern, persistent anxiety, excessive time/energy devoted). Crucially, SSD does NOT require symptoms to be medically unexplained—it can be diagnosed even with a concurrent medical condition if the psychological response is excessive. Illness Anxiety Disorder (IAD) is for patients with minimal somatic symptoms but HIGH fear/preoccupation with having a serious illness. This patient has multiple prominent symptoms—fitting SSD.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.