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After studying this chapter, the student should be able to:

  • Identify and describe somatic symptom disorder and related conditions.

  • Identify the etiology and diagnostic criteria for these disorders.

  • Describe pharmacologic and nonpharmacologic evidence-based treatments for these disorders.


Somatic symptom disorder and related conditions such as conversion disorder present with physical symptoms that cause significant distress or impairment. A summary of somatic symptom disorder and related disorders is provided in Table 41–1. Individuals with these disorders commonly seek care in medical settings, such as primary care or emergency department settings, as opposed to psychiatric settings. Many patients with these disorders experience a chronic course, and they are often high utilizers of the medical system. Although these disorders are not often discussed, the prevalence is significant. Somatic symptom disorder occurs in 5% to 7% of the adult population, and conversion disorder is the second most common diagnosis in neurology clinics. In addition, previous estimates of hypochondriasis were as high as 10% of the population. These patients frequently seek medical care for their symptoms and are often significantly limited by their condition. Symptoms significantly interfere with many patients’ ability to complete activities of daily living such as maintaining employment or living independently.

TABLE 41–1Diagnostic criteria, epidemiology, and comorbidity of somatic symptom disorder and related disorders.

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