14th February 2025

Overview of somatic symptom disorders

These controversial and poorly understood psychiatric disorders feature a complex interplay of physical symptoms, thoughts, emotions and behaviours. The patient presents with an otherwise medically unexplained physical symptom, which is thought to be caused by underlying psychological distress.

They are distinct from syndromes that involve deliberate falsification of symptoms, either for material gain (malingering) or for the psychological reward of occupying the sick role (factitious disorder, also known as Munchausen’s syndrome).

They can result in significant distress and functional deficits. Although the physical symptom may not have a traditional medical cause, the distress and suffering is always real.

Risk factors include female sex, specific personality traits (‘repressed’, i.e. reduced ability to express or describe emotion, ‘distressed’ or ‘neurotic’, i.e. increased tendency to experience negative emotions), recent or past stressors (including childhood abuse), and trauma-related psychiatric illness, e.g. PTSD, dissociative disorder.