American Board of Internal Medicine (ABIM) Certification Practice Exam

What is one primary requirement for the diagnosis of somatic symptom disorder?

1. At least one somatic symptom with no distress

2. Excessive thoughts or behaviors not linked to physical symptoms

3. Persistence of somatic symptoms for less than 6 months

4. At least one somatic symptom causing distress or interference with daily life

The correct answer is: At least one somatic symptom causing distress or interference with daily life

The diagnosis of somatic symptom disorder is characterized by the presence of at least one somatic symptom that is associated with significant distress or impairment in social, occupational, or other important areas of functioning. This reflects the core aspect of the disorder, which is the patient's experience of bodily symptoms that are distressing and impact their daily life. In this context, the emphasis is placed on the degree of distress or the impact on functioning caused by the somatic symptom, rather than the mere presence of a physical symptom itself. This aligns with the current understanding in psychiatric guidelines, where the subjective experience of the symptom and its ramifications on an individual's life are crucial determinants in the diagnosis. The other choices do not accurately represent the primary requirement of the disorder. Specifically, the emphasis on the absence of distress or the non-distressing nature of symptoms, the limitation of symptom duration to less than 6 months, and the idea of thoughts or behaviors unrelated to physical symptoms do not encapsulate the essential criteria needed for the diagnosis of somatic symptom disorder. Instead, this disorder requires an acknowledgment of how the symptoms substantially influence the patient's emotional state and functional capability.