A 24-Year-Old Woman Comes to the Office Due to Recurrent

A 24-year-old woman comes to the office due to recurrent episodes of chest pain, palpitations, and shortness of breath over the past few months.  During some episodes, she experiences dizziness, diaphoresis, and paresthesias of the hands.  The episodes last 5-10 minutes, and the patient constantly worries about when and where she will have another one.  She says, "This keeps happening and no one has been able to tell me why.  I'm scared something might be seriously wrong with me."  The patient has been to the emergency department twice in the past month for similar episodes; prior evaluation, including complete metabolic profile, thyroid function tests, arterial blood gas analysis, ECG, cardiac enzymes, and chest x-ray, showed no abnormalities.  Vital signs are within normal limits.  Physical examination is unremarkable.  Which of the following is the most likely diagnosis?

A) Conversion disorder
B) Factitious disorder
C) Generalized anxiety disorder
D) Illness anxiety disorder
E) Panic disorder
F) Somatic symptom disorder

Correct Answer:

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