Use the Following Terms to Answer -The Diagnosis of Someone with Somatic Symptom Disorder Who Shows

Use the following terms to answer:
$\begin{array}{|l|}\hline\text {Care-seeking type }\\\text { Factitious disorder}\\\text { Illness anxiety }\\\text {Persistent }\\\text {Predominant pain }\\\text {Somatic symptom }\\\text {Swallowing symptoms }\\\hline\end{array}$

-The diagnosis of someone with somatic symptom disorder who shows a persistent course of the illness characterized by severe symptoms, marked impairment, and a duration of 6 months or more) could be further refined with the specifier of ____________. Persistent