Somatic Symptom and Related Disorders

Somatoform disorders are common in primary care and are associated with impairment and high health care costs. The biopsychosocial approach is central to the foundations of optimal care for these patients. Potential psychosocial influences on patient suffering should be identified and discussed early in the diagnostic process which is consistent with the new emphasis on positive psychological symptoms in DSM-5. Primary care practitioners (PCPs) should use a stepped-care approach when considering treatment depending on risk profiles. While patients with lower severity can be managed by the PCP, patients with a higher risk profile may need psychotherapy or other specialist care. Psychotherapy, new generation antidepressants, and natural pharmacological products are potentially effective interventions. This chapter also describes Sofu-Net, an example of a complex intervention to help strengthen the connection and communication between PCPs and psychotherapists. An alternative collaborative care approach integrates mental health care and management into primary care.