DIAGNOSTIC PROFILE

Somatic Symptom Disorder

With predominant pain
300.82 (F45.1)

I. INTRODUCTION

A. Client’s Demographics
25 years old, Meredith Coleman was a divorced woman. She live with her parents
and the youngest among her older siblings. Her father was a banker and her mother
was a homemaker. As a child Meredith felt like she was no gaining any attention from
her mother and her mother was favoring her older brother Wallace and embarrassed
about her. She does not feel belong to her peers as she was bigger than them and
she was outspoken and bossy to other children. She had open up with her mother
about her situation with other kids but her mother was not really gave much attention
to her and she felt ignored. When she was young her family lived with her
grandmother and her grandmother required a lot of caring because just survived a
stroke. Her mother was the one taking care of her grandmother, after her
grandmother died she described the experienced being traumatic. Meredith did not
finish her college degree because of her condition and was majored in music.

B. Reason for Referral

The client was presented to the psychologist due to her continuous feeling of uterine
pain even after a surgery to relieve it, her gynecologist told her there is nothing wrong
with her but she kept on insisting that she was feeling pain even after several medical
examinations and consulting to other doctors. Her regular doctor suggested her to
get a psychological evaluation in order to determine the right medical course for her.

II. JUSTIFICATION
This psychologist in training was able to come up with a diagnosis on Somatic
Symptom Disorder With predominant pain (persistent, moderate) 300.82 (F45.1). This
is due to the fact that diagnostic criteria for this disorder have been fully satisfied and met.
Presented below is the detailed diagnosis.

Diagnostic Criteria Given Facts

CRITERION A CRITERION A
One or more somatic symptoms that are
distressing or result in significant disruption When Meredith was younger she
of daily life. experienced having a headache and feel
severe pain with her legs that could occur
once a day and last for a minute or even
more than hours. For three years her legs
became weaker to the point she begun to
used her grandmother’s wheelchair, even
after being evaluated by a neurologist and
had MRIs there are indication that causes
her condition. She also suffered chest pain
that is occurring for the past 6 months.
Meredith’s gallbladder was remove 2 years
ago because she experienced abdominal
distention and uncomfortable bloating
although even after the removal it did not
relieve her from the symptoms. Her most
recent episode was she suffered constant
uterine pain and heavy menstrual bleeding
that make her convince her physician to
perform hysterectomy but still there are no
improvement after the surgery.

CRITERION B CRITERION B
Excessive thoughts, feelings, or behaviors Meredith constantly feeling pain on his legs,
related to the somatic symptoms or chest, head, and uterine which made her
associated health concerns as manifested always ask for doctor’s consultation about
by at least one of the following: her symptoms.

1. Disproportionate and persistent 1. Due to the pain that Meredith is

thoughts about the seriousness of feeling she often goes to her doctor
one’s symptoms. to ask about her condition and
finding relief for it, and if they will tell
her that there are nothing wrong her
she will get angry saying that she is
 not insane.
2. Persistently high level of anxiety 2. Meredith always feel pain either in
about health or symptoms. her head, legs, or chest and often
visit her doctor to ease her
symptoms. Although she always
complained about pain she did not
show any high level anxiety aside
being constantly visiting the doctor
for check-up.

3. Excessive time and energy devoted 3. She often goes to doctor’s

to these symptoms or health appointment due to her feeling of
concerns. constant pain that resulted to her
divorce as her husband complained
the cost of the medical bill.

CRITERION C CRITERION C
Although any one somatic symptom may Meredith felt that her legs is getting weaker
not be continuously present, the state of for over 3 years which also resulted for her
being symptomatic is persistent (typically to use a wheelchair.
more than 6 months).

Specifier: Specifier:
With predominant pain Meredith was constantly feeling uterine
pain, chest pain, headaches and leg pains.
Her symptoms changes but last for months,
to the point it cause impairment to her
studies, marriage, and daily living.

III. TREATMENT RECOMMENDATION

Somatic symptom disorder often respond to psychotherapy and medication. Psychotherapy
can help the client deal with or manage chronic physical discomfort, particularly cognitive
behavioral therapy in which it will provide the client the information on to best deal with the
condition, providing help in reducing stress. Also family therapy can be effective in
examining family relationship and improving family support and functioning. For medication,
an antidepressant medication or other psychiatric medication can provide relief from the
physical symptoms that stem from somatic symptom disorder. Treatment is often aimed at
managing conflict at home or coping with secondary problems, such as problems with work
and social functioning.

IV. COMORBIDITY
Somatic Symptom disorder has a high comorbidity with other medical disorder but with the
case of Meredith her symptoms does not show any other medical disorder’s symptom and
even after several surgeries and test there are no indication that could explain her symptoms
medically.