Abstract
OBJECTIVE
To propose a simpler, more empiric, and patient-centered category for classifying physical symptoms that are "etiologically neutral," that is, not reliant on the assumption that symptoms that is poorly explained from a medical standpoint must de facto be psychological in origin.
METHODS
Theoretical analysis, narrative review, and proposal.
RESULTS
Studies have revealed several limitations in the current classification of somatoform disorders, including the poor reliability of lifetime symptom recall, the difficulty in adjudicating physical versus psychological explanations, and the stigma in assigning patients with medically unexplained symptoms to an Axis I psychiatric disorder. Physical symptom disorder (PSD) is proposed as a diagnostic category that would reside on Axis III (rather than Axis I) and replace somatization disorder, undifferentiated somatoform disorder, and pain disorder. PSD would consist of one or more physical symptoms currently present, not fully explainable by another medical or psychiatric disorder (with the exception of functional somatic syndromes), causing functional impairment. Duration must be at least 6 months, and severity could be graded as mild, moderate, or severe using a 15-symptom checklist (PHQ-15). Finally, the type of symptoms or symptom syndromes present in the patient could be specified.
CONCLUSIONS
PSD should be considered as a simpler and more inclusive diagnosis to replace several somatoform diagnoses currently in use.
TY - JOUR
T1 - Physical symptom disorder: a simpler diagnostic category for somatization-spectrum conditions.
A1 - Kroenke,Kurt,
PY - 2005/07/12/received
PY - 2005/12/19/revised
PY - 2006/01/12/accepted
PY - 2006/4/4/pubmed
PY - 2006/10/6/medline
PY - 2006/4/4/entrez
SP - 335
EP - 9
JF - Journal of psychosomatic research
JO - J Psychosom Res
VL - 60
IS - 4
N2 - OBJECTIVE: To propose a simpler, more empiric, and patient-centered category for classifying physical symptoms that are "etiologically neutral," that is, not reliant on the assumption that symptoms that is poorly explained from a medical standpoint must de facto be psychological in origin. METHODS: Theoretical analysis, narrative review, and proposal. RESULTS: Studies have revealed several limitations in the current classification of somatoform disorders, including the poor reliability of lifetime symptom recall, the difficulty in adjudicating physical versus psychological explanations, and the stigma in assigning patients with medically unexplained symptoms to an Axis I psychiatric disorder. Physical symptom disorder (PSD) is proposed as a diagnostic category that would reside on Axis III (rather than Axis I) and replace somatization disorder, undifferentiated somatoform disorder, and pain disorder. PSD would consist of one or more physical symptoms currently present, not fully explainable by another medical or psychiatric disorder (with the exception of functional somatic syndromes), causing functional impairment. Duration must be at least 6 months, and severity could be graded as mild, moderate, or severe using a 15-symptom checklist (PHQ-15). Finally, the type of symptoms or symptom syndromes present in the patient could be specified. CONCLUSIONS: PSD should be considered as a simpler and more inclusive diagnosis to replace several somatoform diagnoses currently in use.
SN - 0022-3999
UR - https://www.unboundmedicine.com/medline/citation/16581354/Physical_symptom_disorder:_a_simpler_diagnostic_category_for_somatization_spectrum_conditions_
DB - PRIME
DP - Unbound Medicine
ER -
