A woman with a history of pulmonary embolism develops persistent health worries. What is the most likely diagnosis?

In this scenario, the most likely diagnosis is somatic symptom disorder. This disorder is characterized by the presence of one or more somatic symptoms that are distressing or result in significant disruption of daily life, along with excessive thoughts, feelings, or behaviors related to the symptoms. Given the woman’s history of pulmonary embolism, it is understandable that she may develop ongoing health worries and exhibit heightened concern about her health status.

The persistent nature of her health worries suggests that she is not simply fabricating symptoms (as seen in factitious disorder or malingering) or solely focused on the fear of having a serious illness without significant somatic symptoms, which is indicative of illness anxiety disorder. In contrast to these other conditions, somatic symptom disorder encompasses both the physical symptoms and the psychological distress tied to those symptoms, making it a fitting diagnosis for the scenario presented.

The nuances of somatic symptom disorder highlight how real health concerns can one lead to persistent anxiety and distress. Since this woman has a valid medical history that could understandably provoke ongoing worries, her case aligns more closely with somatic symptom disorder than the other options presented.