The clinical inadequacy of the DSM-5 classification of somatic symptom and related disorders: an alternative trans-diagnostic model

CNS Spectr. 2016 Aug;21(4):310-7. doi: 10.1017/S1092852915000760. Epub 2015 Dec 28.

Abstract

The Diagnostic and Statistical of Mental Disorders, Fifth Edition (DSM-5) somatic symptom and related disorders chapter has a limited clinical utility. In addition to the problems that the single diagnostic rubrics and the deletion of the diagnosis of hypochondriasis entail, there are 2 major ambiguities: (1) the use of the term "somatic symptoms" reflects an ill-defined concept of somatization and (2) abnormal illness behavior is included in all diagnostic rubrics, but it is never conceptually defined. In the present review of the literature, we will attempt to approach the clinical issue from a different angle, by introducing the trans-diagnostic viewpoint of illness behavior and propose an alternative clinimetric classification system, based on the Diagnostic Criteria for Psychosomatic Research.

Keywords: Clinimetric; DSM-5; Diagnostic Criteria for Psychosomatic Research; illness behavior; somatic symptom.

Publication types

  • Review

MeSH terms

  • Conversion Disorder / classification
  • Diagnostic and Statistical Manual of Mental Disorders
  • Factitious Disorders / classification
  • Humans
  • Hypochondriasis / classification
  • Illness Behavior
  • Medically Unexplained Symptoms*
  • Somatoform Disorders / classification*