cultural/social norms that devalue and stig matize psychological suffering as compared
with physical suffering. Differences in medical care across cultures affect the presentation,
recognition, and management of these somatic presentations. Variations in symptom pre-
sentation are likely the result of the interact ion of multiple factors within cultural con-
texts that affect how individuals identify and classify bodily sensations, perceive illness,
and seek medical attention for them. Thus, somatic presentations can be viewed as expres-
sions of personal suffering inserted  in a cultural and social context.
All of these disorders are characterized by  the prominent focus on somatic concerns
and their initial presentation mainly in medical rather than mental health care settings. So-
matic symptom disorder offers a more clinica lly useful method of characterizing individ-
uals who may have been considered in the pa st for a diagnosis of somatization disorder.
Furthermore, approximately 75% of individuals previously  diagnosed with hypochon-
driasis are subsumed under the diagnosis of  somatic symptom diso rder. Howe ver, about
25% of individuals with hypoch ondriasis have high health anxiety in the absence of so-
matic symptoms, and many such individuals’ symptoms would not qualify for an anxiety
disorder diagnosis. The DSM-5 diagnosis of illness anxiety disorder is for this latter group
of individuals. Illness anxiety disorder can be considered eith er in this diagnostic section
or as an anxiety disorder. Because of the st rong focus on somatic concerns, and because ill-
ness anxiety disorder is most often encountere d in medical settings, for utility it is listed
with the somatic symptom and re lated disorders. In conversion  disorder, the essential fea-
ture is neurological symptoms that are foun d, after appropriate neurological assessment,
to be incompatible with neurological pathophysiology. Psychological factors affecting