Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis

Abstract

Background In 2013, the diagnosis of somatic symptom disorder (SSD) was introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This review aims to comprehensively synthesize contemporary evidence related to SSD. Methods A scoping review was conducted using PubMed, PsycINFO, and Cochrane Library. The main inclusion criteria were SSD and publication in the English language between 01/2009 and 05/2020. Systematic search terms also included subheadings for the DSM-5 text sections; i.e., diagnostic features, prevalence, development and course, risk and prognostic factors, culture, gender, suicide risk, functional consequences, differential diagnosis, and comorbidity. Results Eight hundred and eighty-two articles were identified, of which 59 full texts were included for analysis. Empirical evidence supports the reliability, validity, and clinical utility of SSD diagnostic criteria, but the further specification of the psychological SSD B-criteria criteria seems necessary. General population studies using self-report questionnaires reported mean frequencies for SSD of 12.9% [95% confidence interval (CI) 12.5–13.3%], while prevalence studies based on criterion standard interviews are lacking. SSD was associated with increased functional impairment, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Relevant research gaps remain regarding developmental aspects, risk and prognostic factors, suicide risk as well as culture- and gender-associated issues. Conclusions Strengths of the SSD diagnosis are its good reliability, validity, and clinical utility, which substantially improved on its predecessors. SSD characterizes a specific patient population that is significantly impaired both physically and psychologically. However, substantial research gaps exist, e.g., regarding SSD prevalence assessed with criterion standard diagnostic interviews.

Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic

“…Our results are consistent with previous studies in which prior psychological symptom burden has been found to be a risk factor for PSS (Voigt et al, 2013 ; Klaus et al, 2015 ; Löwe et al, 2021 ). In the analysis of an earlier follow-up time point of the here presented sample, baseline psychological symptom burden was found to be a predictor of somatic symptom burden in a cohort without prior SARS-CoV-2 infection after 8 weeks (Engelmann et al, 2022 ).…”

Prevalence and Predictors of Somatization in Peruvian Undergraduate Students during the COVID-19 Pandemic

“…In addition, our results suggest that being in a relationship is considered as a risk factor towards experiencing more severe somatic symptoms; previous studies have found mixed results regarding this issue, since some indicated no particular effect of relationship status on somatic symptoms [ 55 ] and others suggested that being single may be a protective factor as it reduces the likelihood of getting infected [ 56 ]. Daily hours of sleep was a strong predictor of somatic symptom severity, an expected result since difficulties sleeping are in fact manifestations of the somatic syndrome [ 57 ]; besides, the COVID-19 pandemic brought multiple stressors that affected the sleep quality of most people [ 58 ]. No significant relationships were found regarding age, employment status, body mass index, or the number of semesters completed by the participants.…”

Evolution of Psychosomatic Diagnosis: From Masked Depression to Somatic Symptoms and Related Disorders

“…Affected individuals experience substantial impairment in social functioning, with the risk of social withdrawal [13]. Subdiagnoses of Somatic Symptoms Disorder include the following: conversion disorder, illness anxiety disorder, psychological factors, and factitious disorder [16].…”