Abstract
BACKGROUND: Self-reported breast implant illness (BII) has been found to be associated with anxiety as well as medically diagnosed anxiety and depression. Somatic symptom disorder (SSD) is a relatively common mental health condition that includes anxiety and somatic symptoms, often without a clear cause. METHODS: We evaluated patients with BII symptoms, with or without a history of an anxiety disorder, for findings consistent with SSD. A total of 120 women were evaluated in 2 cohorts, 60 women with somatic symptoms and breast implants desiring explantation as well as 60 women desiring explantation without BII symptoms. Patient demographics, a patient survey, and validated anxiety scale and somatic symptom scale measurements were obtained. RESULTS: Patients with a history of an anxiety disorder and BII symptoms had very high levels of anxiety and highly elevated somatic symptom scores. Patients with a combined diagnosis of anxiety and BII symptoms demonstrated an SSD prevalence of 70.2%, with the difference between the BII/anxiety group and other groups statistically significant (P < 0.01). Other patients with BII symptoms and no history of anxiety had a lower SSD prevalence (21.7%). Patients without a history of BII had little to no SSD inclusion. CONCLUSIONS: Our data suggest that a significant subset of patients with somatic symptoms have findings consistent with a breast implant-associated somatic symptom disorder. Patients with persistent or excessive thoughts about somatic symptoms will benefit from counseling and referral to an SSD specialist if they wish to maintain breast implants.