Classification of somatic syndromes in ICD-11

As a part of the its current revision of the International Classification of Diseases (ICD), the WHO is proposing major changes to the somatoform section of the chapter on Mental and Behavioral Disorders. This article reviews the basis for these changes and presents the highlights of the new category being proposed.

As currently classified in ICD-10, somatoform disorders have major problems that limit their clinical utility. Among these are the negative criterion specifications for the diagnosis of the disorders, the rarity of the prototype categories, and the imprecise boundaries between them. To respond to these problems, a new category of Bodily Distress Disorder (BDD) is proposed to replace the current categories. The proposed category is defined by a simplified set of criterion specifications that are based on the presence of positive psycho-behavioral features.

The new category, still in proposal stage, offers the prospect of responding to the need for a reliable diagnosis of clinically significant somatic preoccupations that are common in the community as well as in routine clinical practice. It is expected that improved diagnosis should aid the correct identification of these conditions and enhance the ability of clinicians to provide effective treatment.