Qualitative Investigation Of The Diagnostic Criteria For Somatic Symptom Disorder According To DSM-5 In Patients With And Without Somatic Illnesses - Info and Reading Options

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The diagnostic criteria for somatoform disorders in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) included the presence of physical complaints that could not sufficiently be attributed to an organic disease. This definition was perceived as unscientific and stigmatizing. Furthermore, it was criticized for supporting a dualism between body and mind, which posits that a symptom not explained by organic causes must be attributable to a mental disorder. In the diagnostic criteria for somatic symptom disorder published in DSM-5 in 2013, the diagnostic category was fundamentally revised. It now requires distressing somatic symptoms to be present, while the distinction between symptoms with and without an underlying biomedical condition, as well as the diagnostic criterion regarding the sheer number of symptoms, has been eliminated. One of the most important innovations is that somatic symptom disorder now also includes positive psychological criteria, such as the presence of excessive and disproportionate thoughts, feelings, and behaviors related to physical complaints and one’s health. Research has shown that these new diagnostic criteria are more reliable, valid, and clinically better accepted than the previous ones. However, the psychological criteria (Criterion B) are also the subject of critical discussions. For instance, it remains unclear when symptom-related thoughts, feelings, and behaviors should be considered inappropriate or excessive. Instead, the content of Criterion B remains vague and does not include concrete suggestions for quantification. Moreover, there is evidence for the existence of other potentially relevant psychological factors that are associated with the severity of symptoms, the limitation of quality of life, or the utilization of healthcare services, which are not yet included in the DSM-5 diagnostic criteria. Current research on the diagnosis of somatic symptom disorder is predominantly quantitative in nature, and there is little research on the applicability of the diagnosis in patient groups with underlying somatic diseases.

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