Somatic Symptom Disorder: Definition, Causes and Treatment

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  • 0:07 Somatization Disorder
  • 1:27 Diagnosis
  • 3:46 Causes & Treatment
  • 6:21 Lesson Summary
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Lesson Transcript
Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

What happens when someone has symptoms of being ill, but doctors can't find anything wrong with them? They might have somatic symptom disorder (SSD). In this lesson, we'll look closely at the symptoms, causes, and treatment of somatic symptom disorder.

Somatic symptom disorder

Something's wrong with Meredith, but no one seems to know what. Over the past few years, she's had pain in her uterus, her stomach, and her arm, and severe headaches, too. She even had surgery to remove her uterus because it was giving her so much trouble, but the pain didn't go away. Her doctors can't find anything physically wrong with her, and her mother thinks she's just faking.

But, Meredith actually feels the pain, and she just doesn't know what to do about it anymore. Meredith might be suffering from somatic symptom disorder, a psychological disorder that involves experiencing at least four different physical symptoms without a medical problem to explain them. Somatic symptom disorder is one of several somatoform disorders, which are all similar in that they are all characterized by physical symptoms without obvious physiological causes.

What sets somatic symptom disorder apart is that the physical symptoms are general and not really related to each other. Whereas the symptoms of other somatoform disorders are typically relegated to one part of the body, symptoms of somatic symptom disorder can appear in many different places around the body, like with Meredith, whose affected body parts include her uterus, stomach, arm, and head.


Imagine for a moment that you're a psychologist, and Meredith comes to see you. The doctors can't find anything wrong with her, and yet she's still experiencing physical issues. Could she have somatic symptom disorder? In order to find out, you check the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short. This is a book that psychologists use to help them diagnose patients with psychological disorders. The most commonly used version is the DSM-IV.

According to the DSM-IV, there are several criteria for diagnosing somatic symptom disorder.

1. Physical symptoms that begin before age 30, continue for several years, and cause problems in the life of the patient.

Meredith's symptoms began in her early 20s, and she's had problems in her life because of them, including the fact that her relationship with her mother is strained because her mother believes Meredith is faking it.

2. A combination of four pain symptoms, two gastrointestinal symptoms, one sexual symptom, and one brain-related symptom.

The four pain symptoms are those we listed before (her uterus, stomach, arm, and head). As you talk to Meredith, it becomes clear that she has many other symptoms as well. She says that she vomits a lot and has sensitivity to certain foods, both gastrointestinal symptoms. Her period is irregular, which is a sexual symptom. And, she's felt paralysis in her right leg several times, which is a neurological (or brain) symptom.

3. The symptoms cannot be completely explained by a general medical condition.

Some patients may have medical conditions that could explain some of their symptoms, but the severity or number of their symptoms should not be able to be explained by a medical condition. In the case of Meredith, there's nothing physically wrong with her, so she fits this criterion.

4. The patient is not faking.

Meredith is not pretending to have the symptoms; she really does have them. Further, she's not doing anything to make herself have them, like forcing herself to vomit.

Because Meredith fits all four criteria, you are able to diagnose her with somatic symptom disorder.

Causes and Treatment

You might be wondering what could cause something like somatic symptom disorder. After all, it's pretty rare, and most people would agree that it's more than a little odd. Psychologists aren't sure what causes somatic symptom disorder, but there are some theories. The traditional theory about somatic symptom disorder was that it was a response to stress. When confronted with a situation that was stressful or traumatizing, the belief was that some patients would display physical symptoms instead of psychological ones. According to this theory, Meredith is getting physically sick instead of coming down with depression or anxiety.

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