The Covid-19 pandemic has brought with it far-reaching consequences that affect the mental health of a significant population. Those suffering from somatic symptom disorder (SSD) present a significant focus on physical symptoms, with excessive thoughts and behaviours, to an extent that results in major distress and dysfunction. Aggravation of SSD could be associated with various stressors, including the current pandemic, and culminate in an increased severity of the base presentation.

The authors present the case of an elderly man with previous diagnosis of SSD which began to aggravate and evolve into a depressive psychotic state, precipitated by the beginning of the Covid-19 pandemic.

The authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question as well as presenting a clinical case as compliment.

With the pandemic overwhelming the globe, the literature has demonstrated a significant correlation with aggravation of mental health and psychiatric cases. The patient in question was previously followed in consultation for SSD. With the pandemic acting as precipitating stressor, the patient demonstrated a significant aggravation in his base presentation with the development of psychotic depression. He was subsequently hospitalized with implementation of psychotherapeutic and psychopharmacological methods, with remission of the psychotic state, with poor response of the SSD.

External stressors are an important influence on psychiatric disorders. Whenever potential life stressors, especially those that exert influence on a global scale, the psychiatrist should be attentive to the possibility of significant aggravation of a stabilized clinical picture and offer support.

No significant relationships.

Somatoform disorders, previously diagnosed according to DSM-IV-TR and ICD-10, are shifting towards somatic symptom disorder in DSM-V and bodily distress disorder in ICD-11.

Before using the current criteria, because the new diagnostic entities can identify a larger pool of patients with various physical complaints and diagnoses, it is essential to consider the physical and psychiatric comorbidities that have an important role in deciding the pharmacological treatment.

We conducted a retrospective observational study on a group of 169 patients previously diagnosed with a type of somatoform disorder and hospitalized between January 2015 - January 2021 in a psychiatric emergency hospital in Cluj-Napoca, Romania.

Male:female ratio was 1:1.41. The mean age was 52.35±13.3 years, the mean period of hospitalization was 12±5.39 days. 54% of patients lived in urban areas, and almost half of them were married. Most patients were not professionally active and did not receive a superior education. Most patients had one hospitalization and had at least one physical and one psychiatric comorbidity. The most frequent somatic comorbidities were: cardiovascular, metabolic, rheumatological, gastrointestinal, endocrinological, and neurological, and the most frequent psychiatric ones were: depressive, personality, anxiety, neurocognitive, and substance use disorders. The most frequent type of somatoform disorders were: undifferentiated somatoform disorder and somatization disorder. Regarding psychiatric treatment, antidepressants, antipsychotics, benzodiazepines, anticonvulsants, and hypnotics were used. No correlations were observed between the presence of depressive or anxiety disorders and somatic comorbidities.

ICD and DSM need to clarify diagnostic criteria and develop therapeutical guidelines for this type of patient.

No significant relationships.