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Somatic symptom disorder (SSD) involves unexplained physical symptoms that bring significant functional impairment. It presents one of the more common and most difficult problems in primary care. SSD is seldom “cured” and should be approached as a chronic disease. Recognition, a patient-centered approach, and specific treatments may help alleviate symptoms and distress. Factitious disorder and malingering, although not true SSD, are addressed separately in this chapter because of their similarity in the form of medically unexplained symptoms.

Somatic symptom disorder (SSD) is a new diagnostic term that replaces somatoform disorder in DSM-5, the latest ­version of the diagnostic manual published by the American Psychiatric Association. Use of SSD as the prevalent term will likely increase after DSM-5 becomes widely disseminated following publication in May 2013. The diagnostic labels previously subsumed by somatoform disorders in DSM-4 will also be subsumed by SSD in DSM-5. These disorders have specific courses, symptoms, complaints, and treatments, listed in Table 59-1.

Table 59-1.Somatoform disorders, factitious disorder, and malingering.a

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