Stability of somatoform symptoms--implications for classification.
OBJECTIVE
To investigate the stability of somatoform symptoms/disorders.


METHODS
A literature search was done to select studies reporting data on stability of medically unexplained physical symptoms.


RESULTS
Whereas individual symptoms vary over time, grouping symptoms into syndromes seems to create stable features. There are substantial problems with the use of lifetime diagnosis, favoring classification approaches that require only present state symptoms. Further, doctors' ratings that symptoms are "medically unexplained" is highly problematic and reduces interrater reliability. Misdiagnoses and overlooking of organic conditions are in the same range as for other psychiatric (and many organic) disorders; therefore, this does not seem to reduce the stability of the diagnoses of somatoform disorders.


CONCLUSIONS
These results indicate how the classification of somatoform disorders can be improved. Some new diagnostic criteria are suggested that could be considered in the revision of Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V).
Rief
Winfried
W
Department of Clinical Psychology und Psychotherapy, Philipps University of Marburg, Gutenbergstrasse18, D-35032 Marburg, Germany. rief@staff.uni-marburg.de
Rojas
Graciela
G
D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005500:Follow-Up Studies; D006801:Humans; D011320:Primary Health Care; D013001:Somatoform Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D013577:Syndrome