Horn Mathilde, Fovet Thomas, Sobanski Vincent, Amad Ali
Centre Lille Neuroscience & Cognition (INTERACTIONS), Univ. Lille, INSERM U1172, CHU Lille, 59000, Lille, France.
Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.
BMC Psychiatry. 2025 May 26;25(1):550. doi: 10.1186/s12888-025-06918-w.
Somatic Symptom Disorder (SSD) is defined as persistent and clinically significant somatic symptoms accompanied by excessive and inappropriate health-related thoughts, feelings and behaviours. The causes of SSD are not fully understood, but the biopsychosocial model posits that they result from vulnerability to both precipitating and maintaining factors that contribute to the progression of symptoms from short-term/acute distress presentation to a more persistent and even disabling problem.
We report the case of a patient who developed a SSD after a prolonged period of medical care that ultimately led to the diagnosis of pheochromocytoma. After surgery (that should have resolved the initially-presenting problem), both physical symptoms and distress persisted, suggesting that SSD was present and remained even after treatment of the original/underlying physical symptom profile.
This case report emphasizes the importance of early diagnosis of SSD when a patient presents with excessive health-related thoughts or behaviors, and not only after physical diagnoses have been ruled out. Based on the predictive model of SSD, early SSD treatment may help to reduce physical symptoms, regardless of their etiology. Diagnosing SSD and investigating the potential etiology of physical symptoms should be seen as complementary approaches, rather than opposing ones.
躯体症状障碍（SSD）被定义为持续存在且具有临床意义的躯体症状，并伴有过度和不适当的与健康相关的想法、感受及行为。SSD的病因尚未完全明确，但生物心理社会模型认为，其源于对促发和维持因素的易感性，这些因素导致症状从短期/急性痛苦表现发展为更持久甚至致残的问题。
我们报告了一例患者，该患者在接受长期医疗护理后患上了SSD，最终被诊断为嗜铬细胞瘤。手术后（这本应解决最初出现的问题），躯体症状和痛苦仍然存在，这表明SSD存在，甚至在治疗了最初的/潜在的躯体症状后依然存在。
本病例报告强调，当患者出现过度的与健康相关的想法或行为时，早期诊断SSD很重要，而不仅仅是在排除躯体诊断之后。基于SSD的预测模型，早期SSD治疗可能有助于减轻躯体症状，无论其病因如何。诊断SSD和调查躯体症状的潜在病因应被视为互补的方法，而非相互对立的方法。
