Somatic Symptom Disorder Definition/Description • • Predominant pain Belief that these symptoms represent the manifestations of a serious illness which persists despite negative medical investigations. Epidemiology • More common in females than males Clinical Features • • • • • • Lack of medical support Clinically signifncat distress and functional impairment Symptoms are produced unconsciously Not as a result of a malignancy/faculitous disorder - Disorder of voluntralt faking symptmps Can lead to anxiety/depressive disorder Can lead to unessary medications/surgery Diagnosis DSM V A. More than one somatic symptom leading to distress or significant disruption to daily life B. Disproportionate thoughts, anxiety and excessive time/energy developed to symptoms and health concerns C. State of being symptomatic is persistent and continuous (typically for more than 6 months) Management Approach • • • • Review the patient’s medical record and consider contacting any specialists that the patient have consulted in the past Perform a detailed history and physical examination including the following aspects: - Diagnostic studies to rule out a treatable medical condition - Empathic interview techniques using trauma-informed approach - Risk factors in the patient’s history e.g. history of childhood abuse/neglect or sexual abuse and past psychiatric diagnosis - Review cultural context Ask the patient how their symptoms affect their mood Patient education - Ask about their expectations from management - Ask what they may be causing their symptoms • • • Medical management - Minimise unnecessary studies and procedures ➔ Regular visits with the same primary care physicians ➔ Coordinate with other healthcare professionals that the patient may be consulting ➔ Review symptom severity ➔ Avoid medication prescriptions Psychotherapy Treat comorbid psychiatric conditions e.g. depression, anxiety