Case report: Can somatic symptom disorder be an iatrogenic disease? 2025 Horn et al

[Andy]

Abstract

Background
Somatic Symptom Disorder (SSD) is defined as persistent and clinically significant somatic symptoms accompanied by excessive and inappropriate health-related thoughts, feelings and behaviours. The causes of SSD are not fully understood, but the biopsychosocial model posits that they result from vulnerability to both precipitating and maintaining factors that contribute to the progression of symptoms from short-term/acute distress presentation to a more persistent and even disabling problem.

Case presentation
We report the case of a patient who developed a SSD after a prolonged period of medical care that ultimately led to the diagnosis of pheochromocytoma. After surgery (that should have resolved the initially-presenting problem), both physical symptoms and distress persisted, suggesting that SSD was present and remained even after treatment of the original/underlying physical symptom profile.

Conclusions
This case report emphasizes the importance of early diagnosis of SSD when a patient presents with excessive health-related thoughts or behaviors, and not only after physical diagnoses have been ruled out. Based on the predictive model of SSD, early SSD treatment may help to reduce physical symptoms, regardless of their etiology. Diagnosing SSD and investigating the potential etiology of physical symptoms should be seen as complementary approaches, rather than opposing ones.

Open access

 

[Kitty]

I wonder why it isn't titled "Ways to blame the patient when a treatment doesn't work"?

 

[Jonathan Edwards]

Somatic Symptom Disorder (SSD) is defined as persistent and clinically significant symptoms accompanied by inadequate and inappropriate health-related thoughts, feelings and behaviours by the doctor.

 

[rvallee]

LOL, LMAO even.

RFK Jr's got nothing on those guys. They are pros at a game he is a mere amateur at.

Diagnosing SSD and investigating the potential etiology of physical symptoms should be seen as complementary approaches, rather than opposing ones.

Oh no, buddy, they are like religion and science, don't kid yourself.

 

[Utsikt]

Until 2013, somatoform disorders were defined negatively by the lack of medical condition that may account for the physical symptoms. DSM-5 introduced a positive diagnosis of SSD, which no longer requires the persistent symptoms to be medically unexplained. SSD may thus co-occur with another medical condition if physical symptoms persist and are associated with disproportionate thoughts, feelings or behaviors [1]. This major evolution raises questions regarding the mechanisms underlying SSD but also the potential role of the healthcare system implicated in potential contributions to the emergence of this disorder.

I’m tempted to define the use of SSD as a positive sign of gaslighting.