Somatic symptom disorder — MCCQE Part 1 MCQ

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ModeratePsychiatrySomatic symptom disorderMCCQE Part 1

A 44-year-old woman has years of distressing pain and gastrointestinal symptoms despite negative investigations, frequent reassurance seeking and functional impairment. Which of the following is the most likely diagnosis?

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Correct answer: C — Somatic symptom disorder

Somatic symptom disorder is the single best answer because the age, timing, examination findings and investigations in the vignette fit Somatic symptom disorder better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian psychiatric guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian psychiatric guidance