309Somatic Symptom and
Related Disorders
Somatic symptom disorder  and other disorders with  prominent somatic symp-
toms constitute a new ca tegory in DSM-5 called somatic symptom an d related disorders.  This
chapter includes the diagnoses of somatic sy mptom disorder, illness anxiety disorder, con-
version disorder (functional neurological symptom disorder), psychological factors affect-
ing other medical conditions, factitious disorder, other specified somatic symptom and
related disorder, and unspecified somatic symp tom and related disorder. All of the disor-
ders in this chapter share a common feature: the prominence of soma tic symptoms associ-
ated with significant distress and impairment . Individuals with diso rders with prominent
somatic symptoms are commonly encountered in primary care and other medical settings
but are less commonly encountered in psychiatric and other mental health settings. These
reconceptualized diagnoses, based on a reorga nization of DSM-IV somatoform disorder di-
agnoses, are more useful for primary care and other medical (nonpsychiatric) clinicians.
The major diagnosis in this diagnostic cl ass, somatic symptom disorder, emphasizes
diagnosis made on the basis of positive sy mptoms and signs (distressing somatic symp-
toms plus abnormal thoughts,  feelings, and behaviors in response to these symptoms)
rather than the absence of a medical explanat ion for somatic symptoms. A distinctive char-
acteristic of many individuals with somati c symptom disorder is not the somatic symp-
toms per se, but instead the way they present and interpret them. Incorporating affective,
cognitive, and behavioral components into th e criteria for somatic symptom disorder pro-
vides a more comprehensive and accurate reflecti on of the true clinical picture than can be
achieved by assessing the somatic complaints alone.