Somatic Symptom Disorder: a narrative review of literature of the last twenty years

Abstract

Background: according to the DSM-5, somatic symptom disorder (SSD) is characterized by physical symptoms that cause a disruption in patient functioning and by excessive preoccupation about symptoms. There is a high prevalence of SSD in the general population, with a range going from 5 to 7% and with a relevant cost burden for healthcare system. So, it appears useful to know what the state of art regarding this significant problem is. Methods: the aim of this work is to review studies published in the last twenty years, using Pubmed, Scopus, Cochrane and PsichInfo, as search engines and the following terms: “somatic symptom disorder”, “somatization”, “somatoform disorder”, “medically unexplained symptoms”, “bodily distress syndrome” and “psychosomatic medicine”, linked by the Boolean operator “OR”. Exclusion criteria are studies in languages other than English and French, studies about pediatric population and animals, type of publication other than journal articles. Results: etiology of SSD is multifactorial, involving internal and external factors. Neuroanatomical studies show the presence of abnormalities in CNS of SSD patients. Assessment still results a problematic field, due to uncertainty of nosography. The therapeutic approach toward SSD can be pharmacological, but also the psychotherapy in its different approaches. Conclusions: the issue of SSD is complex and needs further investigations. To correctly analyze this phenomenon, it is necessary to consider both psychological and organic factors, being on the base of this disorder. It is worth to develop this research because an improvement of the state of art about this matter could lead to improve the approach to SSD, resulting in better quality of patients’ life.

Keywords

• somatic symptom disorder
• somatization
• somatoform disorder
• medically unexplained symptoms
• bodily distress syndrome
• psychosomatic medicine.