MBBS OSCE · Psychiatry
OSCE — Somatic Symptom Disorder & Related Disorders
Eight-minute OSCE station on Somatic Symptom Disorder & Related Disorders: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Somatic Symptom Disorder & Related Disorders.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
The somatic symptom and related disorders (SSRD) are a DSM-5-TR cluster defined by EXCESSIVE thoughts, feelings, and behaviours related to somatic symptoms or health concerns, NOT by absence of disease. Somatic Symptom Disorder (SSD): one or more distressing somatic symptoms plus disproportionate concern, persistent health anxiety, or excessive time/energy devoted to symptoms for at least 6 months. Illness Anxiety Disorder (IAD, hypochondriasis): preoccupation with having or acquiring a serious illness with minimal/no somatic symptoms. Conversion/FND: motor or sensory symptoms incompatible with recognised neurological disease, NOT consciously produced. Factitious = falsification/induction fo
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Excessive health anxiety with disproportionate symptom concern, repeated doctor |
| Safety | Motor or sensory symptom incompatible with recognised neurological disease (e.g. |
| Safety | Frequent ER presentations with multiple normal investigations and escalating ana |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.