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A 46-year-old male presents with a 14-month history of persistent worry about having colon cancer despite two normal colonoscopies, normal lab work, and reassurance from his gastroenterologist. He reports no significant physical symptoms, no pain, no change in bowel habits, no weight loss. However, he spends several hours daily researching colon cancer online, checks his stool multiple times daily, and has scheduled three additional specialist appointments in the past month. His daily functioning is significantly impaired by this preoccupation. The most appropriate diagnosis is:
Explanation
The SSD versus illness anxiety disorder distinction is straightforward once the key principle is understood: somatic symptom disorder requires prominent, distressing somatic symptoms plus excessive thoughts, feelings, or behaviors. Illness anxiety disorder involves preoccupation with having a serious illness with minimal or absent somatic symptoms. The presence or absence of somatic symptoms is the dividing line.
Key Takeaway
Illness anxiety disorder involves preoccupation with illness despite minimal or no somatic symptoms, while somatic symptom disorder requires one or more prominent, distressing somatic symptoms.