Bodily symptoms: new approaches to classification.
OBJECTIVE
To examine the current approach to classifying bodily symptoms in both psychiatry and medicine and to suggest better alternatives.


METHODS
Theoretical analysis, narrative review, and theoretical proposal.


RESULTS
The assumptions that (a) bodily pathology can always explain bodily symptoms, (b) psychopathology can always explain bodily symptoms in the absence of bodily pathology, and (c) dichotomizing bodily symptoms into "medical" and "psychiatric" types is clinically useful were all found to have questionable validity and utility.


CONCLUSIONS
Alternative multiaxial diagnostic approaches for the classification of bodily symptoms are proposed. These are intended to (a) give greater prominence to bodily symptoms in their own right, (b) allow etiology to be conceptualized in terms of multiple factors, and (c) provide the basis for integrating medical and psychiatric approaches to patient care.
School of Molecular and Clinical Medicine, University of Edinburgh, Edinburgh, UK.
Michael
M
Sharpe
Richard
R
Mayou
Jane
J
Walker
D002908:Chronic Disease; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D010146:Pain; D011602:Psychophysiologic Disorders / Q000145:classification* / Q000175:diagnosis* / Q000473:pathology