Which statement best differentiates somatic symptom disorder from illness anxiety disorder?

• A. Somatic symptom disorder is characterized by prominent physical symptoms with excessive thoughts; illness anxiety disorder is preoccupied with illness despite minimal symptoms
• B. Illness anxiety disorder requires multiple somatic symptoms
• C. Both disorders require significant impairment in functioning
• D. Illness anxiety disorder is defined by fear of losing control

Answer: (A)

The main idea is where the distress and focus lie: in somatic symptom disorder, the person has one or more real, distressing physical symptoms and spends excessive time and thoughts on those symptoms; the symptoms drive the concern and impairment. In illness anxiety disorder, there are little to no physical symptoms, but there is a persistent fear of having or developing a serious illness, with a high level of health-related anxiety and behaviors aimed at checking or avoiding doctors.

So the best statement captures that difference: somatic symptom disorder involves prominent physical symptoms paired with excessive worry about them, whereas illness anxiety disorder centers on preoccupation with illness despite minimal or no somatic symptoms.

Why the other options aren’t correct: illness anxiety disorder does not require multiple somatic symptoms; the defining feature is health anxiety despite few or mild symptoms. The notion that both disorders require significant impairment overstates the distinguishing feature, since the emphasis in illness anxiety can be on health worry with or without marked impairment. The idea that illness anxiety disorder is defined by fear of losing control is not how the diagnosis is described.