matters. Any reassurance by the doctor that the symptoms are not indicative of serious
physical illness tends to be short-lived and/ or is experienced by the individuals as the
doctor not taking their sympto ms with due seriousness. As  the focus on somatic symp-
toms is a primary feature of the disorder, in dividuals with somatic symptom disorder typ-
ically present to general medical health servic es rather than mental health services. The
suggestion of referral to a mental health spec ialist may be met with surprise or even frank
refusal by individuals with somatic symptom disorder.
Since somatic symptom disorder is associated with depressive disorders, there is an in-
creased suicide risk. It is not known whethe r somatic symptom disorder is associated with
suicide risk independent of its asso ciation with depressive disorders.
Prevalence 
The prevalence of somatic symptom disorder is not known. However, the prevalence of
somatic symptom disorder is expected to be higher than that of the more restrictive DSM-
IV somatization disorder (<1%) but lower than  that of undifferentiated somatoform dis-
order (approximately 19%). The prevalence of  somatic symptom disorder in the general
adult population may be around 5%–7%. Fema les tend to report more somatic symptoms
than do males, and the preval ence of somatic symptom diso rder is consequently likely to
be higher in females.
Development and Course
In older individuals, somatic symptoms and concurrent medical illnesses are common,
and a focus on Criterion B is crucial for making the diagnosis. Somatic symptom disorder
may be underdiagnosed in older adults either because certain somatic symptoms (e.g.,
pain, fatigue) are considered part of normal aging or because illness worry is considered