A patient repeatedly presents to his primary care physician with extreme distress about his mild health symptoms, including headaches and fatigue. Although the physician reassures him that these are not symptoms of a severe illness, the patient fears the worst and continues to devote significant time to worrying about his health. Which diagnosis is most likely for this patient?

Question

A patient repeatedly presents to his primary care physician with extreme distress about his mild health symptoms, including headaches and fatigue.  Although the physician reassures him that these are not symptoms of a severe illness, the patient fears the worst and continues to devote significant time to worrying about his health.  Which diagnosis is most likely for this patient?

Quizplus · Accepted Answer

11ecba2d_0d8f_1c18_a3bf_0b5c9e2c3f3e_MD0008_00 The somatic symptom and related disorders (SSRD) are a group of disorders in which bodily (somatic) symptoms or illnesses are associated with psychological factors. SSRD diagnoses include somatic symptom disorder, conversion disorder, illness anxiety disorder, and factitious disorder. Somatic symptom disorder (SSD) is characterized by extreme concern regarding one or more actual physical symptoms (eg, fatigue, pain). Individuals with SSD typically have a high level of anxiety about their health and devote significant time and energy to their symptoms (eg, repeated doctor visits, researching symptoms online). Therefore, a patient who repeatedly presents with extreme distress about his mild health symptoms and who devotes significant time to worrying about his health despite his primary care physician's reassurances would most likely be diagnosed with somatic symptom disorder. (Choice A) Dissociative disorders are characterized by disruptions in memory and identity. A diagnosis of a dissociative disorder would not best account for this patient's symptoms. (Choice B) Personality disorders, which are characterized by inflexible and enduring patterns of thought and behavior (ie, personality traits) that differ markedly from social norms, are stable over time and across environments while causing significant distress or impairment in functioning. A diagnosis of a personality disorder would not best account for this patient's symptoms. (Choice D) Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive and uncontrollable worry about a range of topics (eg, health, finances, career, relationships). Although some individuals with GAD may have health-related concerns, these are not the primary focus of their worry as in SSD. Educational objective: Somatic symptom disorder (SSD) is characterized by extreme distress and concern regarding one or more actual bodily/physical symptoms (eg, fatigue, pain).

A Patient Repeatedly Presents to His Primary Care Physician with Extreme