I Am Here to Make You Inferior? - A Case Report of Somatic Symptom Disorder

Somatic symptom disorder is characterized by 6 or more months of a general and non-delusional preoccupation with fears of having a serious disease based on the person's misinterpretation of bodily symptoms. That causes significant distress and impairment in one's life; and a subset of individuals with disorder has poor insight about the presence of this disorder. Persons with this disorder augment and amplify their somatic sensations; they have low thresholds and low tolerance for physical discomfort. They may focus on bodily sensations, misinterpret them and become alarmed by them because of a faulty cognition. A case of 56yrs ? old married male was diagnosed as SSD admitted to Psychiatry ward with a history of total duration of 30-35 yrs having complains of multiple physical pains over different part of body mainly over left shoulder pain, backache, body-ache, abdominal pain and excessive worries about to pain and his health. He is spending most of the time and energy for relieving pain by applying hot water bag over different part of body for more than 4-5hrs daily. He also stopped going to work. Over period of time he developed depressive symptoms due to his illness, so he thought death will be better option than life. For all complain he had more than 30-35 consultation to various physician. He had done all investigation, those were normal. His physical and central nervous system examination were normal. He mostly complains about his physical conditions but in therapy we only focused on emotional issue of his life and tried to explain that pain may have underlying emotional background. Combination pharmacological management and Cognitive behaviour therapy were tried. We tried to make him learn about Reassurance, Stress reduction, more adoptive methods of interacting with family and society like Social skill training and gave an insight about his illness.