The patient meets the diagnostic criteria for somatic symptom disorder. These criteria include having at least one somatic symptom causing distress or interference with daily life; excessive thoughts, feelings, and behaviors related to the somatic symptoms; and persistence of somatic symptoms for at least 6 months. Furthermore, potential medical causes must be excluded. She has two somatic symptoms (chest and abdominal pain), which have been present for well over 6 months and have no identifiable organic source despite thorough diagnostic testing. Her missed time from work demonstrates interference with daily functioning, and her frequent utilization of health care resources and daily research of Internet resources are indicative of excessive concern over her symptoms.

Conversion disorder involves one or more symptoms of abnormal sensation or motor function that are not explained by a medical condition and are inconsistent with physical examination findings. This patient's symptoms are somatic rather than neurologic, thus eliminating the possibility of conversion disorder.

Patients with factitious disorder deliberately falsify symptoms or inflict injury upon themselves or another. Although patients with factitious disorder may have no apparent external benefit for their fabricated illness, this patient has no evidence (such as tenderness on abdominal examination) that she is falsifying her symptoms.

Illness anxiety disorder (formerly known as hypochondriasis) is characterized by excessive concern over general health and is associated with undue focus on health-related activities. However, unlike this patient with debilitating somatic symptoms, patients with illness anxiety disorder have minimal or no somatic symptoms.