Okay, let's tackle this question. The patient is a middle-aged man who's been chronically worried about his health. He had fears about bowel cancer for years and now is preoccupied with heart disease, even though the doctor says the extra beats are benign. The key here is his persistent health anxiety despite medical reassurance.

First, I need to recall the diagnostic criteria for hypochondriasis or somatic symptom disorders. The DSM-5 has Somatic Symptom Disorder, which involves a significant distress about physical symptoms that leads to excessive thoughts, feelings, or behaviors about the symptoms. The patient's focus on health concerns is persistent, and he's seeking reassurance repeatedly.

The options might be something like Somatic Symptom Disorder, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, or Delusional Disorder. The correct answer is Somatic Symptom Disorder. Hypochondriasis is now part of Somatic Symptom Disorder in DSM-5. The key here is the preoccupation with having a serious illness despite medical reassurance.

Generalized Anxiety Disorder involves excessive worry about various aspects, not just health. OCD would involve compulsions, not just anxiety about health. Delusional disorder would involve fixed, false beliefs, but the patient here is concerned about real symptoms but misinterprets them. So the wrong options can be ruled out based on these distinctions.

Clinical pearl: Remember that Somatic Symptom Disorder is characterized by excessive focus on physical symptoms leading to significant distress or impairment, even after medical evaluation confirms no serious illness. The key is the persistent worry and seeking reassurance despite evidence to the contrary.

**Core Concept**
This question tests the clinical distinction between somatic symptom disorders and other anxiety-related conditions. **Somatic Symptom Disorder** involves persistent, excessive preoccupation with physical health concerns, often leading to repeated medical evaluations and reassurance-seeking despite negative findings.

**Why the Correct Answer is Right**
The patient’s chronic health anxiety, spanning multiple organ systems (bowel, heart), and persistence despite medical reassurance aligns with **Somatic Symptom Disorder**. Key features include disproportionate focus on physical symptoms, excessive thoughts about having a serious illness, and distress that impairs daily functioning. His fixation on "extra beats" (benign palpitations) as a sign of heart disease illustrates the core diagnostic criterion of health-related preoccupation.

**Why Each Wrong Option is Incorrect**
**Option A:** *Generalized Anxiety Disorder* involves chronic, global worry about various life domains (e.g., work, family), not exclusive health preoccupation.
**Option B:** *Obsessive-Compulsive Disorder* requires intrusive, repetitive thoughts (obsessions) and ritualistic behaviors (compulsions) to neutralize anxiety—not health-focused reassurance-seeking.
**Option D:** *Delusional Disorder* involves fixed, false beliefs (delusions) that are not subject to change by evidence; this patient’s concerns are plausible (e.g., cancer, heart disease), not bizarre or implausible.

**Clinical Pearl / High-Yield Fact**
For exams, remember **Somatic Symptom Disorder** is diagnosed when a patient’s health anxiety persists despite medical evaluation and reassurance. Avoid conflating it with **Illness Anxiety Disorder** (DSM-5), which focuses on fear of illness without prominent physical symptoms.

**Correct Answer: C. Somatic Symptom Disorder**

✓ Correct Answer: B. Hypochondriasis