Step 2

Psychiatry 7

A 39-year-old woman presents to the clinic for 9-month history of chest pain. She explains that the pain is constant at rest but sometimes worsens with exertion. She has tried taking acetaminophen, but it does not relieve the pain. She has missed multiple days of work and family outings over this period because of the pain. Previous evaluations with many healthcare providers have included cardiac enzyme levels, electrocardiograms, chest x-ray and CT angiography, echocardiography, and an exercise stress test which have all been normal. She is anxious and frustrated that no diagnosis has been established. She has spent many hours daily searching for answers on the internet. She has no other medical problems. Vital signs and physical examination are normal. Screening for depression and generalized anxiety disorder are negative.

Which of the following is the most likely diagnosis?

  • A) Conversion disorder
  • B) Factitious disorder
  • C) Illness anxiety disorder
  • D) Malingering
  • E) Somatic symptom disorder

Authors

Marina Tawadrous

Editor

Dr. Raj Dasgupta

Last updated

Nov 07, 2022

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