Somatic symptom disorder: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Medical | * Medical conditions | ||
** [[Irritable bowel syndrome]] | ** [[Irritable bowel syndrome]] | ||
** [[Fibromyalgia]] | ** [[Fibromyalgia]] | ||
** | ** Endocrine disorders | ||
* Psychiatric | *** [[hyperparathyroidism]] | ||
** [[Panic disorder]] | *** thyroid disorders | ||
*** [[Addison's disease]] | |||
*** [[insulinoma]] | |||
*** [[panhypopituitarism]] | |||
**Poisonings: [[botulism]], [[Carbon_monoxide_toxicity|carbon monoxide]], [[heavy metals]] | |||
** [[Porphyria]] | |||
** [[Multiple sclerosis]] | |||
** [[Systemic lupus erythematosus]] | |||
** [[Eponyms_(T-Z)#Wilson.27s_disease|Wilson's disease]] | |||
** [[Myasthenia gravis]] | |||
** [[Eponyms_(F-L)#Guillain-Barr.C3.A9_syndrome|Guillain-Barré syndrome]] | |||
** [[Uremia]] | |||
* Psychiatric conditions | |||
** [[Panic_attack|Panic disorder]] | |||
** [[Generalized anxiety disorder]] | ** [[Generalized anxiety disorder]] | ||
** [[Depression|Depressive disorders]] | ** [[Depression|Depressive disorders]] | ||
Revision as of 11:16, 23 February 2017
Background
- Somatic symptoms associated with distress and impairment that cannot be medically explained
- Most common symptom is pain — may be specific, generalized, or nonspecific (eg, fatigue)
- May represent normal bodily sensations (eg, borborygmus)
- May occur concurrently or secondarily to a medical condition
- Typically encountered in primary care and other medical settings
- Less commonly encountered in psychiatric and other mental health settings
Clinical Features
DSM-5 Diagnostic Criteria for Somatic Symptom Disorder[1]
- One or more somatic symptoms that are distressing or result in significant disruption of daily life.
- Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following:
- Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
- Persistently high level of anxiety about health or symptoms.
- Excessive time and energy devoted to these symptoms or health concerns.
- Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).
Differential Diagnosis
- Medical conditions
- Irritable bowel syndrome
- Fibromyalgia
- Endocrine disorders
- hyperparathyroidism
- thyroid disorders
- Addison's disease
- insulinoma
- panhypopituitarism
- Poisonings: botulism, carbon monoxide, heavy metals
- Porphyria
- Multiple sclerosis
- Systemic lupus erythematosus
- Wilson's disease
- Myasthenia gravis
- Guillain-Barré syndrome
- Uremia
- Psychiatric conditions
Evaluation
Difficult to diagnose, as often a diagnosis of exclusion. Refer to the patient's medical record for indication of repeated visits or recurrent testing.
Management
Close outpatient psychotherapy focused on establishing and maintaining a relationship with the patient.
Disposition
Home
See Also
External Links
References
- ↑ American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.