Which of the following medication needs to be taken with 350 calories of food?

A. Worry about health despite no symptoms. This describes illness anxiety disorder (formerly hypochondriasis), where individuals have an excessive fear of having a serious illness despite minimal or no physical symptoms. Unlike factitious disorder, these individuals are not fabricating symptoms but are genuinely convinced they are sick.

B. Normal voluntary and sensory dysfunction. This does not describe any recognized psychiatric disorder. However, conversion disorder (functional neurological symptom disorder) involves involuntary neurological symptoms (e.g., paralysis, blindness) without a medical cause, whereas factitious disorder involves intentional symptom fabrication.

C. Worry is out of proportion to the symptoms. This is characteristic of somatic symptom disorder (SSD), where individuals have excessive concern and distress over real but often minor physical symptoms. Unlike factitious disorder, their symptoms are not deliberately produced or exaggerated for attention.

D. Deliberate exaggeration and fabricated symptoms. Factitious disorder (formerly Munchausen syndrome) involves intentionally faking, exaggerating, or inducing medical symptoms to assume the "sick role". Unlike malingering (which is done for external rewards like financial gain), factitious disorder is driven by an internal psychological need for medical attention.

A. Psychotherapy. Cognitive-behavioral therapy (CBT) is the first-line treatment for somatic symptom disorder (SSD). It helps patients recognize and modify maladaptive thoughts about their physical symptoms, reducing distress and improving coping mechanisms.

B. Antipsychotics. Antipsychotic medications are not typically recommended for SSD unless there is a comorbid psychotic disorder or severe delusional thinking. SSD is primarily driven by excessive health-related anxiety and preoccupation with physical symptoms, not psychosis.

C. Anti-anxiety medications. Short-term use of anxiolytics (e.g., benzodiazepines) may help with acute anxiety symptoms, but they are not the preferred treatment due to the risk of dependence. SSRIs and psychotherapy are more effective long-term for managing anxiety in SSD.

D. Antidepressants. SSRIs and SNRIs are commonly used to treat SSD, especially when there is underlying depression or anxiety. These medications help reduce excessive preoccupation with physical symptoms and improve overall emotional well-being.