# Bodily Distress (Somatisation) Disorder - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PD10 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Somatic Symptom Disorder - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK532253/ - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text BODILY DISTRESS (SOMATISATION) DISORDER Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PD10 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Somatic Symptom Disorder - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK532253/ Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (8) - Bodily symptoms that cause real distress or get in the way of daily living - Thinking, feeling or behaving around those symptoms in a way that is persistent, out of proportion and eats up time and energy - The picture has run for more than 6 months - The story of the illness is often vague and shifts between tellings - Medical treatments seldom relieve the symptom - Ordinary bodily sensations get read as evidence of disease - Physical activity is avoided and medicines seem to cause side effects readily - The same complaint has been taken to several different providers SIGNS - what you find (5) - Take a full review of systems, not only the area complained of, and examine thoroughly to look for a physical cause - Psychiatric illness often sits alongside it, so do a mental state examination - Record appearance, mood, affect, attention, memory, concentration and orientation - Ask directly about hallucinations, delusions and thoughts of harming self or others [delusions · hallucinations] - Examining also sets a baseline to follow and shows the patient their complaint is being taken seriously TESTS (5) - Keep laboratory testing limited, since most have already had a thorough workup - Over-testing throws up false positives, which lead on to more procedures, more risk and more cost - Testing purely to reassure does not work; it does not relieve the symptoms - A meta-analysis found symptom resolution and illness worry much the same whether or not tests were done - Where a medical cause must be excluded, thyroid tests, a urine drug screen, limited bloods and limited imaging are reasonable IF NOT THIS - what else fits (5) - Vague symptoms spread across systems imitate other illnesses, which is what makes it hard to pin down - Adjustment disorder shows the same out-of-proportion emotional and behavioural response - Body dysmorphic disorder and obsessive-compulsive disorder overlap on that excessive response - Illness anxiety disorder is the nearest neighbour and must be told apart - Fibromyalgia and irritable bowel syndrome are functional too, but usually without the excessive thoughts or behaviour Source StatPearls "Somatic Symptom Disorder" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult Persistent, distressing bodily symptoms with excessive health-seeking behaviour, not explained by another condition; the GP manages with a validating explanation and regular scheduled follow-up rather than symptom-chasing investigation, adding an antidepressant such as sertraline if anxiety or depression coexist, and referring to psychiatry for refractory cases. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why Persistent, distressing bodily symptoms with excessive health-seeking behaviour, not explained by another condition; the GP manages with a validating explanation and regular scheduled follow-up rather than symptom-chasing investigation, adding an antidepressant such as sertraline if anxiety or depression coexist, and referring to psychiatry for refractory cases. Caution New or changing physical signs must not be dismissed as purely somatic - keep reassessing for organic disease. No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. RED FLAG - Significant functional impairment or risk of self-harm. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)