Somatic symptom disorder: definition, causes, symptoms, and treatment

Somatic symptom disorder, also known as somatoform disorder, is characterized by the presence of one or more distressing physical symptoms that lead to excessive thoughts, feelings, or behaviors related to those symptoms.

The causes of somatic symptom disorder include childhood abuse and neglect, poor emotional awareness, heightened sensation awareness, history of substance and alcohol abuse, existing personality disorders, and psychosocial triggers.

The symptoms of somatoform disorder include an inconsistent medical history, the presence of symptoms that are seldom improved by medical treatment, patient misinterpretation of typical sensations as a medical issue, avoiding physical activity, and seeking medical care from multiple sources. 

Treatment options for somatic symptom disorder include cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), and antidepressants. 

What is somatic symptom disorder?

Somatic symptom disorder is a complex psychiatric condition characterized by the presence of one or more distressing and often disabling physical symptoms. These symptoms might range from pain, exhaustion, and gastrointestinal issues to neurological issues or sensory impairments. 

What distinguishes somatic symptom disorder (SSD) from other medical conditions is the excessive and disproportionate focus on these symptoms, often accompanied by excessive worry, anxiety, or preoccupation with their potential meaning or seriousness.

Furthermore, individuals with somatic symptom disorder frequently exhibit a pattern of persistent and maladaptive behaviors related to their symptoms. These behaviors may include frequent medical visits, excessive testing, and a strong belief in the presence of a severe underlying illness, despite medical evaluations yielding inconclusive or negative results.

It’s crucial to understand that somatic symptom disorder does not always indicate deliberate deceit or malingering. Instead, it often involves genuine distress and suffering, albeit with a disproportionate focus on physical symptoms. 

How common is somatic symptom disorder?

Somatic symptom disorder is relatively common, with a prevalence of 5% to 7% in the general population, according to a 2016 article written by Stuart L. Kurlansik, PhD, and Mario S. Maffei, MD for the 2016 issue of the American Family Physician. 

The article adds that its prevalence puts the condition among the most prevalent patient concern categories in the primary care context. Furthermore, a 2014 study by Croicu et al., published in the Medical Clinics of North America states that patients who initially have acute somatic symptoms go on to develop a chronic somatic illness in 20% to 25% of cases.

What are the causes of somatic symptom disorder?

The causes of somatic symptom disorder are complex, frequently encompassing an interplay of biological, psychological, and social elements. The common causes of somatic symptom disorder are listed below. 

• Childhood abuse and neglect
• Poor emotional awareness
• Heightened sensation awareness
• History of substance and alcohol abuse
• Existing personality disorders
• Psychosocial triggers

1. Childhood abuse and neglect

Childhood abuse and neglect are upsetting events that can negatively impact a person’s mental and physical health for a long time. Childhood abuse encompasses physical, emotional, or sexual mistreatment, while neglect refers to the failure of caregivers to provide essential physical and emotional care. These adverse childhood experiences are strongly associated with the development of SSD.

In fact, a 2023 study on childhood trauma and adult somatic symptoms published in Psychosomatic Medicine found that certain somatic symptoms in adulthood can be traced back to traumatic experiences in childhood, notably emotional and sexual abuse.

Individuals who have endured abuse or neglect during their formative years often develop maladaptive coping mechanisms, including somatic complaints, as a way to deal with the emotional pain and distress associated with their traumatic past. Somatic symptom disorder can serve as a means of diverting attention away from the psychological pain, allowing them to focus on physical symptoms instead.

2. Poor emotional awareness

Poor emotional awareness refers to an individual’s limited ability to recognize, understand, and effectively manage their own emotions. This deficiency in emotional intelligence can contribute to the development of somatic symptom disorder in several ways. 

Individuals with poor emotional awareness often struggle to express their emotional distress through traditional means, such as verbal communication. Consequently, they may turn to bodily complaints as an alternative outlet for their emotional turmoil. 

Rather than acknowledging and addressing their emotions directly, they manifest psychological distress in the form of physical symptoms. This process is sometimes unconscious, as they may not readily recognize the connection between their emotions and somatic complaints.

3. Heightened sensation awareness

An individual’s increased sensitivity to physical discomfort and body sensations is referred to as heightened sensation awareness. Similarly, a study by Schrepf et al., published in the December 2016 issue of The Journal of Pain defines heightened somatic awareness (SA) as the heightened awareness of a wide range of somatic feelings and symptoms. 

The study further states that individuals who are high in SA are more likely to recognize and report non-specific symptoms, such as feeling faint, short of breath, or trembling in their muscles. Higher SA levels have been associated with the prevalence of chronic pain diseases such as irritable bowel syndrome (IBS), fibromyalgia (FM), and temporomandibular disorder (TMD). 

individuals with heightened sensation awareness may have a lower threshold for noticing and reacting to physical sensations. This can lead to a heightened state of arousal, making them more susceptible to experiencing somatic symptoms, which in turn reinforces their belief that something is medically wrong.

4. History of substance and alcohol abuse

A history of substance and alcohol abuse pertains to a recurring and problematic pattern of consuming a range of substances, including alcohol and narcotics, which has resulted in adverse effects on the physical, psychological, and social welfare of the individual. 

Substance and alcohol abuse can lead to the development of somatoform disorder through several mechanisms. First, the direct physical consequences of substance abuse can produce real physical symptoms that may be mistakenly attributed to medical conditions. 

For example, alcohol abuse can lead to liver damage or gastrointestinal issues, while drug abuse can affect various organ systems, causing pain and discomfort. Individuals with a history of substance abuse may become hyper-focused on these symptoms, believing them to be indicative of a severe medical issue.

A 2001 comparative study by Laukkanen et al., published in the Journal of Adolescent Health demonstrated that heavy drinking was linked to negative social self-image and psychosomatic symptoms in girls, including pain, sleep disorders, feelings of tension, anxiety, and depression. 

Second, substance misuse and mental health issues including anxiety and depression frequently co-occur. These comorbidities can exacerbate the development of SSD, as individuals may experience emotional distress related to their substance abuse and turn to somatic symptoms as a way to express or cope with their emotional pain.

Finally, according to a study by Green et al., published in the December 2001 issue of The Clinical Journal of Pain, women who claimed long-term abuse had considerably higher anxiety, pain, and physical symptoms, and were more likely to indicate a history of substance abuse than those who reported abuse solely in childhood or adulthood.

5. Existing personality disorders

Existing personality disorders refer to enduring and pervasive patterns of behavior, cognition, and inner experience that deviate markedly from the expectations of the individual’s culture and lead to significant impairment in social and occupational functioning. 

Certain personality disorders can contribute to the development of somatic symptom disorder, including narcissistic personality disorder, antisocial personality disorder, histrionic personality disorder, borderline personality disorder, and avoidant personality disorder, according to a 2020 literature review by Eduardo D. Espiridion and Stacie A. Kerbel published in Cureus. 

Findings of a 2008 study by Sansone et al., published in The Primary Care Companion to the Journal of Clinical Psychiatry indicate that those with BPD (borderline personality disorder) symptoms who seek primary care services are more likely to report having greater somatic complaints. The study goes on to add that the attempt to maintain a victim position may account for the prevalence of physical or mental symptoms in BPD. 

Jerome Kroll, in his book, The Challenge of the Borderline Patient: Competency in Diagnosis and Treatment published in 1988 by W.W. Norton & Company, stresses how important it is for adults with BPD to continue to be victims. He emphasized that borderline persons influence other people to act on them, typically in a negative, rejecting, or aggressive way, but occasionally in a compassionate way, saying that victimhood is a fundamental motif in comprehending borderlines.

According to Kroll, borderline individuals maintain their infantilization and reliance on others by projecting an image of fragility and incapacity. So, it’s possible that having a lot of physical symptoms makes it easier for the person to interact with others, especially health care workers.

Similarly, individuals with histrionic personality disorder often seek attention and may manifest their emotional needs through somatic complaints to gain the sympathy and support of others. Narcissistic personality disorder, on the other hand, can lead to a preoccupation with one’s own physical appearance and health, resulting in an exaggerated concern over minor bodily discomforts.

6. Psychosocial triggers

External events or circumstances that have a substantial impact on an individual’s psychological and emotional well-being, potentially contributing to the development of somatic symptom disorder, are referred to as psychosocial triggers. These triggers might vary greatly, but they frequently include stress, trauma, or emotional issues.

Examples of psychosocial triggers include the loss of a loved one, a traumatic event like an accident or abuse, chronic stress due to work or family issues, or unresolved emotional conflicts such as relationship problems. 

For instance, a person who experiences the sudden death of a close family member might develop symptoms like headaches, chest pains, or gastrointestinal distress as a way to express or cope with their grief and emotional pain.

Psychosocial triggers can cause SSD through a complex interplay between emotional distress and physical sensations. When individuals experience intense stress or emotional turmoil, their bodies may respond with physical symptoms due to the release of stress hormones. 

This can lead to a heightened awareness of bodily sensations and, in some cases, the misinterpretation of normal bodily functions as signs of illness. The persistent focus on these physical symptoms and the distress they cause can lead to the development and maintenance of the condition.

What are the symptoms of somatic symptom disorder?

The symptoms of somatic symptom disorder primarily involve the presence of distressing and often chronic physical complaints. The most common symptoms of somatic symptom disorder are listed below. 

• Inconsistent medical history
• Medical interventions do not alleviate symptoms
• Interpreting normal sensations as symptoms of illness
• Avoiding physical activity
• Seeking medical care from multiple sources

1. Inconsistent medical history

Inconsistent medical history refers to a pattern in which an individual presents with a multitude of unrelated or frequently changing medical complaints over time, often with varying accounts of previous diagnoses, treatments, and medical experiences. This inconsistency is a common symptom of somatic symptom disorder. 

Individuals with the disorder frequently seek medical attention for their distressing physical symptoms, and their medical history may reveal a history of multiple, often unrelated, medical evaluations, tests, and treatments, which do not provide a clear or consistent explanation for their symptoms.

This inconsistency arises from the nature of somatic symptom disorder, where the primary focus is on the physical symptoms rather than an actual underlying medical condition. It’s important to note that individuals with this disorder are not intentionally deceptive; they genuinely experience the distressing symptoms. 

However, their perception and interpretation of these symptoms can be influenced by emotional distress and preoccupation, leading to an ever-changing medical history as they seek validation and answers for their discomfort.

2. Medical interventions do not alleviate symptoms

When medical interventions do not alleviate symptoms, this means that individuals experience distressing physical symptoms that persist despite multiple medical evaluations, treatments, and interventions. 

Individuals with somatoform disorder often seek medical help for their symptoms, and healthcare providers may perform various tests, prescribe medications, or recommend treatments based on the presented complaints. However, the symptoms persist or may even worsen, despite these medical efforts. This can lead to a frustrating cycle of seeking medical care, undergoing multiple diagnostic tests, and trying various treatments without relief.

Because it highlights the dissociation between the physical symptoms and any underlying medical disease, this symptom is predictive of somatic symptom disorder. 

While people do suffer the uncomfortable symptoms, they are often rooted in emotional distress and psychological factors rather than a straightforward medical cause. This symptom keeps one convinced that there is a major or undetected medical problem, which in turn keeps one preoccupied with health issues.

3. Interpreting normal sensations as symptoms of illness

Interpreting normal sensations as symptoms of illness involves a pattern in which individuals misinterpret common bodily sensations or minor discomforts as indicative of a severe medical condition. 

In other words, they perceive everyday physical sensations, which are typically harmless and temporary, as symptoms of a serious illness. This misinterpretation is a hallmark feature of somatic symptom disorder because it leads to excessive concern and preoccupation with health issues.

Individuals with the condition tend to be hyper-aware of their bodily sensations and may focus intently on even minor changes, such as a slight headache, muscle twinge, or digestive discomfort, interpreting these as alarming signs of a severe underlying medical problem. 

This misinterpretation often leads them to seek medical attention and undergo numerous tests and evaluations in a persistent quest for a medical explanation, even when there is no clear evidence of a medical issue.

4. Avoiding physical activity

Avoiding physical activity is a symptom of somatoform disorder characterized by an individual’s reluctance or resistance to engage in physical activities, particularly when these activities are perceived as potentially exacerbating their distressing physical symptoms. 

This avoidance can manifest in various forms, such as refraining from exercise, work, or daily tasks that may involve physical exertion. Individuals with somatic symptom disorder often engage in this behavior out of a genuine belief that physical activity might worsen their symptoms or trigger a serious health problem, despite medical evaluations failing to identify any underlying medical condition to justify such concerns.

An article on somatoform disorders published in the 2007 issue of the American Family Physician also states that pain is another possible contributor to the condition’s characteristics of inactivity and social withdrawal, and it frequently co-occurs with anxiety, depression, or substance abuse disorders. 

5. Seeking medical care from multiple sources

Seeking medical care from multiple sources describes the persistent and frequent pursuit of medical evaluation and treatment for distressing physical symptoms from various healthcare providers and specialists. 

People who have this illness frequently see multiple physicians, get tested extensively, and seek advice from a variety of medical specialists, sometimes without any conclusive evidence of an underlying medical disease. They can keep going to numerous clinics, hospitals, and experts in an attempt to get a diagnosis or a treatment for their ailments.

Despite many medical professionals telling them there is no apparent medical cause for their problems, individuals continue to seek medical care, believing that their condition is undetected or that their symptoms require constant medical attention. This habit can increase healthcare use, expenditures, and postpone diagnosis of potential psychiatric causes.

Who is affected by somatic symptom disorder?

Women, individuals with a history of medical conditions, those with a history of trauma or abuse, and people with certain personality traits are the groups of people who are often affected by somatic symptom disorder. 

Females are more likely than males to manifest with somatic symptom disorder, with an estimated female-to-male ratio of 10:1, according to a 2019 article written by William R. Yates, MD for Medscape. A 2001 study by Barsky et al., published in the Journal of General Internal Medicine adds that between 5% and 8% of boys and between 12% and 17% of girls experience childhood sexual assault. Part of the reason why somatic symptoms are more common in women could be explained by the fact that sexual abuse is more common in girls.

Individuals who have experienced chronic or severe medical conditions in the past may also be more susceptible to developing somatic symptom disorder, especially if they become hyper-vigilant about their health.

Experiencing trauma or abuse, particularly during childhood, can increase the risk of developing somatic symptom disorder as a way of coping with emotional upset. In fact, findings of a study by Piontek et al., published in the October 2021 issue of the Child Abuse & Neglect journal indicate that adult somatization and reduced health-related quality of life are both associated with a history of childhood maltreatment, especially sexual, emotional, and physical neglect.

Finally, a 2014 study by Tinakon Wongpakaran and Nahathai Wongpakaran published in Clinical Interventions in Aging states that certain personality traits, such as emotional stability, vigilance, dominance, neuroticism, and alexithymia were found to be associated with somatization in the elderly. 

What are the risk factors for somatic symptom disorder?

Risk factors for somatic symptom disorder are characteristics, conditions, or circumstances that increase the likelihood of an individual developing the condition. The risk factors for somatic symptom disorder are listed below. 

• Suffering from anxiety or depression: Anxiety and depression often co-occur with somatic symptom disorder, and the distress associated with these mood disorders can manifest as physical symptoms. Individuals with anxiety or depression may become preoccupied with their physical health, interpreting minor discomforts as serious medical issues, leading to heightened health-related concerns.
• Receiving a medical diagnosis or recuperating from one: After suffering from a serious or prolonged medical condition, some people may become more anxious about their health and fixated on their physical health. Even when a medical disease has been effectively diagnosed and treated, there may still be cause for concern. Somatoform disorder may arise as a result of a notion that an underlying medical condition is still unidentified or a fear of recurrence.
• Living in chaos: A lifestyle marked by constant stress, instability, and a lack of routine can lead to emotional distress and physical discomfort. Individuals living in chaos may have difficulty managing daily life. Furthermore, the unpredictability and frequent demands of a busy lifestyle might leave little time for self-care and rest, thereby exacerbating health issues.
• Past instances of trauma: Trauma, especially when experienced during childhood or in adulthood, can leave deep emotional scars and impact an individual’s ability to cope with distress. To escape or manage the emotional pain associated with trauma, some individuals may unconsciously redirect their focus onto physical symptoms, viewing them as a more manageable and concrete way to express their suffering.
• Lower social status and educational attainment: A study by Baitha et al., published in the July 2020 issue of Cureus states that high levels of somatic symptom severity were more common among patients with lower socioeconomic position and lower levels of education. The review adds that most studies show a positive association between lower socioeconomic position and poor mental health. In addition to equipping individuals with improved coping mechanisms and skill development, education is believed to influence mental health positively.

How is somatic symptom disorder diagnosed?

Somatic symptom disorder is diagnosed by conducting a  thorough assessment, which may include a comprehensive medical examination, psychological evaluation, and the use of the specific criteria for the condition as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The medical professional may first do an in-depth medical examination, during which the patient’s medical and mental health histories, as well as their present symptoms, are ascertained by physical examination or any recommended laboratory testing. 

In the event that the patient does not suffer from any physical illness, they will likely be referred to a mental health professional for an evaluation of their emotional and psychological well-being to check for symptoms of distress, anxiety, and depression, as well as any familial risk factors. The provider may also consult with the patient about the severity and duration of their symptoms.

Finally, the diagnosis is made using precise criteria for somatic symptom disorder defined in the DSM-5, a generally regarded diagnostic text used by mental health professionals. These criteria include the presence of distressing physical symptoms that substantially impede daily functioning, excessive thoughts, feelings, or behaviors related to these symptoms, a disproportionate focus on health concerns, and these symptoms continue longer than 6 months.

When does somatic symptom disorder occur?

Somatic symptom disorder usually occurs prior to 25 or 30 years of age; however, it may also emerge during adolescence and persists for an extended period of time, according to a 2022 article written by Howard E. LeWine, MD for the Harvard Health Publishing.

On the other hand, a 2021 article titled, “What is Somatic Symptom Disorder?” from the American Psychiatric Association states that the condition typically manifests itself around the age of 30.

Significant life changes or stressors, such as the transition towards adulthood, important life events, or the onset of independence, may also raise the risk of somatoform disorder. A combination of genetic, psychological, and environmental variables can potentially impact the beginning of this condition. 

It is critical to note that somatic symptom disorder may also affect people of all ages, and that early detection and management are critical for properly managing the illness.

What are the treatments for somatic symptom disorder?

Treatments for somatic symptom disorder are therapeutic techniques and treatments targeted at addressing and reducing the disorder’s physical symptoms and related psychological issues. The common treatments for somatic symptom disorder are listed below. 

• Cognitive behavioral therapy (CBT)
• Antidepressants

1. Cognitive behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) is a popular type of psychotherapy that focuses on finding and changing negative thought processes, feelings, and behaviors in order to help people with a wide range of mental health problems. 

When used to treat somatic symptom disorder, cognitive behavioral therapy can be very helpful. People who use this method of therapy are better able to recognize and deal with their excessive fears, fixation on health issues, and wrongly interpreting physical symptoms as signs of illness. 

Through CBT, individuals learn to develop healthier thought patterns and coping strategies, enabling them to manage their somatic symptoms more effectively. CBT can help individuals develop a better understanding of their condition and minimize the suffering associated with physical symptoms by addressing the psychological components that contribute to somatic symptom disorder. 

It encourages a transition from a focus on sickness to a focus on increasing overall well-being, making it a viable and evidence-based therapy choice for somatic symptom disorder.

2. Antidepressants

Antidepressants are medications designed to alleviate symptoms of depression, anxiety, and related mood disorders. They work by targeting and regulating neurotransmitters in the brain, such as serotonin and norepinephrine, to enhance mood and emotional well-being. 

Antidepressants can serve as a treatment option for somatic symptom disorder  because individuals with SSD often experience co-occurring anxiety and depressive symptoms related to their preoccupation with physical complaints.

Selective serotonin reuptake inhibitors, or SSRIs, are a type of antidepressant drug. These drugs function by boosting serotonin levels in the brain by preventing its reabsorption or reuptake in neural cells. Higher amounts of serotonin in the synaptic cleft result, which may help enhance mood and reduce depressive symptoms.

By addressing these mood-related factors, antidepressants such as SSRIs can indirectly help reduce the distress and emotional burden associated with somatic symptoms. When the psychological symptoms are lessened, individuals with SSD may become better equipped to manage their symptoms effectively. 

However, according to a 2023 continuing education activity on somatic syndrome disorders published in StatPearls, a further cause for concern is that individuals with SSD may have a low threshold for detecting side effects, therefore drugs should be started at the lowest dose and raised gradually to achieve a therapeutic effect.

Therefore, it’s crucial to recognize that the use of antidepressants for SSD should be part of a comprehensive treatment plan developed in collaboration with a healthcare provider. The decision to prescribe antidepressants in SSD is typically made when there is a clear indication that mood-related symptoms contribute significantly to the disorder, and medication can complement other therapeutic approaches, such as psychotherapy, to provide comprehensive care.

Can you prevent somatic symptom disorder?

No, you cannot prevent somatic symptom disorder, as its development is influenced by a complex interplay of genetic, psychological, and environmental factors. However, there are certain steps that individuals and healthcare professionals can take to reduce the risk of its development and mitigate its impact. 

Early identification and intervention for emotional distress, anxiety, and mood disorders can be crucial, as these conditions often co-occur with somatic symptom disorder. Promoting healthy coping strategies for stress and emotional difficulties, especially during times of trauma or significant life changes, can be beneficial. 

Additionally, psychoeducation and awareness about somatic symptom disorder can help individuals recognize the signs and seek help when needed, potentially preventing the condition from worsening. 

While it may not be possible to entirely prevent somatic symptom disorder, early recognition and appropriate care can significantly improve an individual’s quality of life and overall well-being.

What to expect with somatic symptom disorder?

With somatic symptom disorder, individuals can expect the presence of distressing physical symptoms, which may include pain, gastrointestinal discomfort, fatigue, neurological complaints, or other bodily sensations. 

Even in cases when there isn’t any conclusive evidence of an underlying medical disease, these symptoms can be extremely persistent and force people to seek frequent medical attention or undertake a battery of diagnostic procedures. 

Furthermore, people with somatic symptom disorder sometimes misunderstand typical body sensations as indicators of a serious illness, leading to increased anxiety and obsession with their health. Their everyday lives and general well-being can be severely impacted by this persistent obsession, which can result in functional impairment, social isolation, and a general decline in quality of life.

Other common expectations with somatic symptom disorder may include a history of seeking medical care from multiple sources, avoidance of physical activity or work, and a chaotic medical history marked by inconsistent accounts of previous diagnoses and treatments. 

Because the symptoms frequently remain despite several medical tests and therapies, patients may also experience inconsistent relief from medical procedures. Individuals with SSD can expect a multifaceted treatment plan that may include psychotherapy, in particular CBT, to better manage their symptoms, decrease their fixation on their somatic symptoms, and enhance their quality of life as a whole. 

What is the difference between somatic symptom disorder and illness anxiety disorder?

The difference between somatic symptom disorder (SSD) and illness anxiety disorder (IAD) lies in their primary focus and presentation. SSD is characterized by the presence of distressing and often chronic physical symptoms, such as pain, exhaustion, or gastrointestinal distress. 

Individuals with SSD genuinely experience these symptoms, which can be disabling and disruptive to their daily lives. The central feature of SSD is the disproportionate and excessive focus on these symptoms, often leading individuals to seek medical attention or engage in frequent medical testing, despite inconclusive or negative results. The key in SSD is the physical symptom itself and its impact on an individual’s life.

In contrast, illness anxiety disorder, formerly known as hypochondriasis, is marked by an intense fear or belief that one has a severe medical condition despite little or no medical evidence to support it. The primary focus in IAD is on the fear of having an illness rather than the presence of actual physical symptoms. 

Individuals with IAD often worry excessively about their health, may engage in “body checking” behaviors, and frequently seek medical reassurance, despite a lack of objective findings to support their fears.

It is important to note, however, that people who suffer from IAD are not making it up. They are legitimately scared that they have a life-threatening, undiagnosed condition, according to a 2022 article written by Ross Goodwin, MD for the Mid-Atlantic Permanente Medical Group.

In summary, while both disorders involve a heightened preoccupation with health, the main distinction lies in the focus on physical symptoms in SSD and the fear of having an illness in IAD.

What is the difference between somatic symptom disorder and conversion disorder?

The difference between somatic symptom disorder and conversion disorder primarily lies in the nature of their symptoms and their manifestation. For instance, people with SSD frequently have debilitating, long-lasting physical symptoms such as weariness, pain, or gastrointestinal problems. 

These physical complaints are real symptoms, and the main characteristic is the overemphasis on them, which frequently results in repeated medical examinations even in cases when a clear medical cause cannot be found.

In contrast, conversion disorder, also called functional neurological disorder, is characterized by central nervous system symptoms like blindness or paralysis that cannot be attributed to any underlying neurological issues, according to an article on conversion disorder from the Children’s Hospital of Philadelphia. 

In summary, the crucial difference between somatic symptom disorder and conversion disorder lies in the type of symptoms they present: presence of one or more distressing and often disabling physical symptoms in SSD and only neurological symptoms like paralysis, weakness, or sensory disruptions in conversion disorder.