14th February 2025

Management of somatic symptom disorders

The dynamic of the doctor-patient relationship is key, including empathy for the patient’s suffering and demonstrating trust that the patient is not faking symptoms. It is also a necessary foundation for setting clear boundaries to avoid unnecessary investigations or treatments. If indulged, these can perpetuate the patient’s maladaptive response to the physical symptom and may cause harm in other ways, e.g. radiation exposure.

Cognitive behavioural therapy will help the patient to develop coping strategies and self-modulation of cognitive, emotional and behavioural responses to the physical symptom. Any other psychiatric conditions should also be treated. Physical therapy may also have a role.

References

• O’Sullivan S. It’s all in your head: true stories of imaginary illness. London: Vintage Books; 2016
• Stonnington C, Driver-Dunckley E, Noe K, Locke D. Conversion and somatic symptom disorders – Symptoms, diagnosis and treatment. [Internet]. BMJ Best Practice. 2021 [cited 2022 Apr 10]. Available from: https://bestpractice.bmj.com/topics/en-gb/989