What they are
In somatic symptom disorder, formerly called somatoform disorders, a person has persistent physical symptoms, such as pain, fatigue or digestive complaints, together with excessive worry, anxiety and time devoted to them. In health anxiety, formerly called hypochondria and now illness anxiety disorder, the core is an intense fear of having or developing a serious disease that normal tests and medical explanations do not resolve.
The symptoms are real. This is not “imagination”.
Signs and symptoms
- Physical symptoms that shift or persist without sufficient explanation in tests
- Many appointments, tests and changes of doctor
- Constant health worries and frequent searching for information
- Brief relief after normal results, followed by new worry
- Avoiding activities for fear of getting worse or ill
How it is diagnosed
The assessment starts by taking symptoms seriously. The psychiatrist reviews the medical history, previous tests and medications and, when useful, talks with the patient’s other doctors. Clinical training and hospital experience help separate what needs physical investigation from what is better treated another way. Depression and anxiety, often present, are also evaluated.
Treatment
- A steady care relationship with one reference doctor, avoiding unnecessary repeated tests
- Psychotherapy, especially cognitive behavioral therapy
- Medication, when indicated, particularly if anxiety or depression are present
- Gradual return to activities
When to see a psychiatrist
When worry about health or physical symptoms takes up much of the day, causes distress and does not ease despite normal tests and medical reassurance.
Follow-up at the practice
At the practice in Campinas, Dr. Petrus Raulino combines a clinical and psychiatric view and proposes regular follow-up, in person or by video.
Staging: text awaiting medical review by Dr. Petrus before publishing.
This content is for information only and does not replace a medical consultation. Diagnosis and treatment depend on an individual assessment. In crisis or having thoughts of suicide? In Brazil call 188 (CVV, 24 hours, free) or go to the nearest emergency room. In an emergency, call 192 (SAMU).