Rethinking somatoform disorders.
OBJECTIVE
From the very moment of their inclusion in contemporary classification systems in psychiatry, the concept of somatization and diagnostic categories of somatoform disorders became a matter of controversy that created an ongoing debate about their validity, reliability and applicability in clinical and research settings. The aim of this review is to provide an insight into the current theoretical, research and clinical dilemmas in the area of somatoform disorders and to illustrate them with brief summaries of scientific papers recently published in this field.


RESULTS
In the period covered by this review, the most valuable scientific contributions to the current state of knowledge on somatoform disorders were (surprisingly numerous) review papers produced by the leading experts in this field. These comprehensive and critical meta-analyses covered historical, conceptual, epidemiological and cross-cultural aspects of somatoform disorders. Another and a relatively smaller group of recently published papers reported on some novel treatment strategies for patients with specific somatoform disorders, their service utilization and health care-related costs.


CONCLUSIONS
If one were to find a common denominator of the papers covered by this review, it is a general agreement amongst their authors that the current concepts of somatization and somatoform disorders have serious theoretical and practical limitations in both research and clinical settings. They suggest that the time has come to seriously rethink these concepts so as to find better nosological solutions for the forthcoming revisions of classification systems in psychiatry and medicine.
Janca
Aleksandar
A
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia. ajanca@cyllene.uwa.edu.au