sometimes represent normal bodi ly sensations or discomfort that does not generally sig-
nify serious disease. Somatic symptoms with out an evident medical explanation are not
sufficient to make this diagnosis. The individu al’s suffering is authen tic, whether or not it
is medically explained.
The symptoms may or may not be associated  with another medical condition. The di-
agnoses of somatic symptom disorder and a concurrent medical illness are not mutually
exclusive, and these frequently occur together . For example, an indi vidual may become se-
riously disabled by symptoms of somatic sy mptom disorder after an uncomplicated myo-
cardial infarction even if the myocardial infarc tion itself did not result in any disability. If
another medical condition or high risk for de veloping one is present (e.g., strong family
history), the thoughts, feelings, and behavior s associated with this condition are excessive
(Criterion B).
Individuals with somatic symptom disorder tend to have very high levels of worry
about illness (Criterion B). They appraise th eir bodily symptoms as unduly threatening,
harmful, or troublesome and often think the worst about their health. Even when there is
evidence to the contrary, some patients sti ll fear the medical seriousness of their symp-
toms. In severe somatic symptom disorder, he alth concerns may assume a central role in
the individual’s life, becoming a feature of his or her identity and dominating interper-
sonal relationships.