What iatrogenic risk is associated with somatic symptom and related disorders (SSRDs)?

• A. Reduced testing and minimal reassurance.
• B. Clear guidelines with no risk.
• C. Frequent patient satisfaction with care.
• D. Excessive testing, unnecessary referrals, and reinforcement of symptom focus due to persistent reassurance or investigations.

Answer: (D)

Iatrogenic risk in somatic symptom and related disorders comes from medical responses that unintentionally reinforce the illness course. When clinicians repeatedly test, offer ongoing reassurance, or refer patients to many specialists, the focus remains on symptoms and perceived disease. That reinforcement can validate the symptom experience, increase attention to physical symptoms, and fuel a cycle of more testing and more medical visits, rather than helping the patient regain functioning. So the scenario that best describes this iatrogenic risk is excessive testing, unnecessary referrals, and reinforcement of symptom focus due to persistent reassurance or investigations.

The other options describe approaches that would not create this reinforcing loop: reducing testing and reassurance, implying no risk; guidelines with no risk, which is not realistic; or patient satisfaction with care, which does not specifically capture the reinforcement of symptom focus that drives iatrogenesis in SSRDs.