Functional Somatic Disorder: A Postmedical Event Stress Disorder?

Functional somatic disorders (FSDs) are characterized by persistent and bothersome physical symptoms associated with impairment or disability. FSD have a significant impact on quality of life, whereas concurrently presenting clinicians with considerable challenges, due to the difficulty in comprehending the reasons for and the mechanisms by which physical symptoms persist. A history of medical events (e.g., severe infections, injuries, or invasive procedures) is common in patients with FSD and has been identified as a potential trigger factor. The emergence of physical symptoms and health-related psychologic symptoms after a stressful medical event provides a compelling basis for comparison with posttraumatic stress disorder (PTSD). We hypothesize that a subset of FSD cases can be conceptualized as a "postmedical event stress disorder," a condition analogous to PTSD. We reinterpret FSD symptoms as consequences of a stressful medical event, detailing the psychopathological processes that may explain their emergence and persistence in a specific subset of patients. While acknowledging key differences between FSD and PTSD, we propose a therapeutic framework for this specific subgroup of FSD patients that draws on successful PTSD treatment models. We conclude by outlining future research to further explore and validate this proposed PTSD-like mechanism.