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Evolution of bodily distress disorders.
Chethan Basavarajappa1, Ajit Bhalchandra Dahale, Geetha Desai
1Department of Psychiatry, NIMHANS, Bengaluru, India.
Current Opinion in Psychiatry
|July 24, 2020
Summary
The classification of somatoform disorders has been updated in DSM-5 and ICD-11, now termed bodily distress disorders. New criteria focus on distressing bodily symptoms and associated psychological factors, aiming for greater clinical utility.
Area of Science:
- Psychiatry
- Psychosomatic Medicine
- Clinical Psychology
Background:
- The nomenclature and classification of somatoform disorders have been revised in the Diagnostic and Statistical Manual (DSM-5) and the International Classification of Diseases (ICD-11).
- Previous classifications emphasized medically unexplained symptoms and specific symptom counts across organ systems.
Purpose of the Study:
- To review the evolving nomenclature and classification of somatoform disorders.
- To highlight the changes introduced in DSM-5 and ICD-11.
- To discuss potential challenges associated with the revised classifications.
Main Methods:
- Review of diagnostic criteria changes in DSM-5 and ICD-11.
- Comparative analysis of previous and current classifications.
- Identification of key shifts in diagnostic emphasis.
Main Results:
- Somatoform disorders are replaced by "bodily distress disorders."
- Emphasis shifted from "medically unexplained" to the presence of distressing bodily symptoms.
- Inclusion of psychological factors (excessive attention, thoughts, behaviors) and a severity qualifier based on impairment.
Conclusions:
- The new "bodily distress disorders" classification aims for increased clinical utility and applicability across healthcare settings.
- Further research is needed to differentiate these disorders from chronic pain classifications.
- The potential for over-psychologizing medical conditions requires careful consideration.
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