Psychosomatic Presentation of Chronic Multisystem Symptoms in a Patient with Major Depressive Disorder

Abstract

Psychosomatic disorders present diagnostic and therapeutic challenges in psychiatric practice, particularly when a psychological disorder is somatically expressed as persistent physical symptoms. We present a case of a 31-year-old female with recurrent major depressive disorder and anxiety, who gradually developed chronic widespread pain alongside multiple somatic complaints in the absence of any organic correlations. Her symptomatology has temporal associations with affective episodes and psychosocial stressors, notably bereavement, and persisted despite comprehensive medical management. Her clinical course was characterized by prominent somatization, illness preoccupation, functional impairment, and only transient or partial response to repeated pharmacological interventions. The biopsychosocial perspective supported her somatic complaints as part of a psychosomatic disorder linked to her underlying affective episodes. This case illustrates the importance of comprehensive psychiatric assessment in identifying somatic symptom presentations and highlights the limitations of a purely organ-focused medical approach. Recognition of psychosomatic mechanisms may reduce unnecessary investigations, and long-term outcomes can be improved by early psychiatric intervention, psychoeducation, and a multidisciplinary approach.