What are persistent somatic symptoms?

Persistent somatic symptoms (PSS) are physical complaints with a duration longer than a few weeks and for which, after adequate medical examination, no somatic condition is found that explains the complaints sufficiently.

Terms used for PSS largely vary: somatoform disorder or somatic symptom disorder, chronic pain disorder, bodily distress disorder, medically unexplained symptoms (MUS) or somatically not enough explained bodily symptoms, functional somatic syndrome or disorder, such as irritable bowel syndrome, chronic fatigue syndrome or fibromyalgia, functional complaints, functional neurological complaints or conversion disorder.

At the general practitioner, 30 – 50% of the presented physical complaints remain somatically insufficiently explained. The prevalence of PSS is also high at somatic outpatient clinics in the hospital: after a new consultation at neurologist, rheumatologist, pulmonologist, gastroenterologist, cardiologist, gynecologist and internist outpatient clinics, these percentages are between 41 – 66%.

More and more biopsychosocial factors are known that can – in a complex and very individual interplay – contribute to the development and maintenance of PSS. 

Even with complaints that have been explained somatically, the burden that people experience often does not correlate with the pathology found. Here too, as with PSS, biopsychosocial factors play a pivotal role, and the boundary may therefore not be so clear. 

If there are PSS that hinder daily life, there are various evidence-based treatment methods.

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