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Somatic symptom disorder — MCCQE Part 1 MCQ

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ModerateSomatic SymptomsSomatic symptom disorderMCCQE Part 1

45-year-old woman presents with multiple distressing symptoms despite repeated negative tests. She frequently changes physicians and is impaired by health anxiety. Which of the following is the most appropriate next step?

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Correct answer: B — Schedule regular validating visits and avoid unnecessary repeated investigations

Schedule regular validating visits and avoid unnecessary repeated investigations is best because structured continuity reduces harm and maintains therapeutic alliance. Provide reassurance only and arrange no follow-up is suboptimal because mental health risk often requires structured follow-up or urgent escalation; Use long-term benzodiazepine monotherapy as default treatment is suboptimal because benzodiazepine monotherapy is rarely an appropriate long-term strategy; Avoid direct risk assessment to preserve rapport is suboptimal because direct assessment of suicide, violence, capacity and substance use is clinically appropriate; Attribute symptoms to personality or culture without assessing illness is suboptimal because diagnostic overshadowing risks missing treatable mental illness. Symptoms are real to the patient even when not explained by disease.

Reference: Canadian psychiatric guidance