Somatic Symptom and Related Disorders
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A diagnosis used when psychological or behavioral factors adversely affect a diagnosed medical condition by influencing its course, interfering with treatment, contributing to health risks, or affecting the underlying pathophysiology -- distinct from a somatic symptom disorder, since a genuine, diagnosed medical condition is present.
This diagnosis applies when psychological or behavioral factors -- such as denial of a medical condition's severity, stress that worsens a physical illness, or poor treatment adherence tied to psychological factors -- have a clinically significant adverse effect on a diagnosed medical condition. Unlike Somatic Symptom Disorder, there is a genuine, well-documented medical condition; the diagnosis captures the psychological factors' negative influence on that condition's course or management.
Can occur at any age and with essentially any medical condition, since it describes a relationship between psychological factors and an existing medical diagnosis rather than a disorder with a specific typical age of onset.
The psychological factors' adverse effect on the medical condition can worsen physical outcomes, increase healthcare utilization, or complicate treatment planning if not identified and addressed.
Poor treatment adherence, minimization or denial of the medical condition's seriousness, and stress-related physiological worsening of the condition are common patterns captured by this diagnosis.
Beliefs about illness, treatment adherence, and the role of stress in physical health vary across cultural contexts, and should be considered when assessing whether a factor is genuinely adversely affecting the medical condition versus reflecting a different, culturally normative way of relating to illness.
A common misconception is that this diagnosis implies the medical condition itself is psychologically caused or not 'real'; the medical condition is genuine and independently diagnosed, and this diagnosis specifically captures psychological factors that are adversely affecting its course, not causing it outright.
Reconsider this diagnosis if there is no genuine, diagnosed medical condition being adversely affected, which would instead point toward Somatic Symptom Disorder or Illness Anxiety Disorder.
A 50-year-old man with diagnosed, poorly controlled diabetes consistently skips his insulin doses during periods of high stress and minimizes the seriousness of his blood sugar readings to his care team, resulting in repeated hospitalizations that his physician attributes in part to this pattern.
Know
Know that a genuine, diagnosed medical condition is required for this diagnosis, distinguishing it from Somatic Symptom Disorder and Illness Anxiety Disorder.
Notice
Notice patterns like poor treatment adherence, denial of severity, or stress-related worsening of the medical condition as characteristic features.
Distinguish
Distinguish from Somatic Symptom Disorder and Illness Anxiety Disorder by the presence of a genuine, diagnosed medical condition whose course is specifically and adversely affected by the psychological factors.
Recognize
A diagnosed medical condition is present, and psychological or behavioral factors adversely affect its course, treatment adherence, associated health risks, or underlying pathophysiology, in a clinically significant way.
Distinguish
Distinguish from Somatic Symptom Disorder and Illness Anxiety Disorder by the presence of a genuine, diagnosed medical condition whose course is specifically and adversely affected by the psychological factors.
Somatic Symptom Disorder (that diagnosis centers on distressing somatic symptoms and excessive thoughts, feelings, or behaviors related to those symptoms, without necessarily a fully explanatory diagnosed medical condition, whereas this diagnosis requires a genuine, diagnosed medical condition whose course is adversely affected by psychological factors), Illness Anxiety Disorder (centers on high anxiety about having or acquiring a serious illness, often with minimal or no somatic symptoms, distinct from this diagnosis's focus on psychological factors worsening an already-diagnosed condition), a mental disorder that independently explains the presentation without a specific adverse effect on a medical condition's course.
Both disorders involve psychological factors intersecting with physical health, which can blur the distinction, but the presence or absence of an actual diagnosed medical condition is the deciding structural feature -- Conversion Disorder is diagnosed in its absence, and Psychological Factors Affecting Other Medical Conditions requires its presence.
Both diagnoses involve a medical condition and psychological symptoms together, which can make the direction of causality easy to mix up without careful evidence review.
Both are sometimes casually described as 'stress affecting health,' but only one requires a diagnosed medical condition whose course is demonstrably worsened by the psychological factor.
Reason
Apply
Recognize a medical-condition-caused psychiatric presentation, and distinguish it from the reversed causal direction of Psychological Factors Affecting Other Medical Conditions.
Distinguish Psychological Factors Affecting Other Medical Conditions, where a psychological factor measurably worsens a diagnosed disease, from Somatic Symptom Disorder's excessive preoccupation with symptoms.
Retrieve
2 question(s) reference this disorder. Practice Psychological Factors Affecting Other Medical Conditions →
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