What distinguishes Somatic Symptom Disorder from Illness Anxiety Disorder in clinical presentation?

• A. SSD presents with minimal somatic symptoms.
• B. SSD features prominent somatic symptoms with excessive thoughts about those symptoms; IAD features preoccupation with a serious illness with minimal or no somatic symptoms.
• C. IAD involves explicit motor symptoms.
• D. IAD and SSD are identical.

Answer: (B)

The key idea is what the person is most worried about. Somatic Symptom Disorder centers on actual bodily symptoms that are distressing or disruptive, with excessive thoughts, feelings, or behaviors focused on those symptoms. Illness Anxiety Disorder centers on a preoccupation with having or acquiring a serious illness, but the somatic symptoms themselves are minimal or not present.

So the best description is that Somatic Symptom Disorder involves prominent somatic symptoms plus excessive concern about those symptoms, whereas Illness Anxiety Disorder involves preoccupation with a serious illness without needing to have significant symptoms already present. For example, SSD would look like someone with ongoing pain who is constantly worried the pain signals a dangerous disease, whereas IAD would look like someone who is intensely worried about having cancer despite normal medical tests and spends a lot of time seeking reassurance. Both conditions involve persistent concerns, but the focus shifts from the symptoms themselves in SSD to the illness threat in IAD.