Diagnosis of Somatic Symptom Disorder Usually clinical criteria Symptoms must be distressing or disruptive of daily life for > 6 months and be associated with at least one of the following: Disproportionate and persistent thoughts about the seriousness of the symptoms Persistently high anxiety about health or the symptoms Excessive time and energy spent on the symptoms or health concerns At first presentation, physicians take an extensive history (sometimes conferring with family members) and do a thorough examination and often testing to determine whether a physical disorder is the cause.