title: Somatoform, factitious, and related diagnoses in the national hospital discharge survey: addressing the proposed DSM-5 revision.
abstract: BACKGROUND
  The DSM-5 working group on the somatoform (SFD) and factitious (FD) disorders has recommended substantial revisions of these categories. The recommendations are based, in part, on anecdotal evidence that the diagnoses are infrequently used.
  
  
  OBJECTIVE
  To assess the assignment rates for SFD, FD, and related diagnoses among general medical inpatients.
  
  
  METHODS
  The National Hospital Discharge Survey was queried for instances of SFD and FD, along with related diagnoses identifying medical cases in which psychological factors play a role. Diagnoses of major depression and generalized anxiety disorder were queried for comparison purposes.
  
  
  RESULTS
  The target diagnoses were assigned far less frequently than published prevalence and recognition rates suggest. Nearly half of the assigned target diagnoses were generic diagnoses (esp. physiological malfunction due to psychological factors) other than SFD or FD. However, the apparent degree of underassignment of the target diagnoses was not dramatically greater than the underassignment observed for major depression and generalized anxiety disorder.
  
  
  CONCLUSIONS
  The results provide empirical support for the impression that physicians do not assign SFD and FD diagnoses in recognized cases, but do not strongly support the assertion that these diagnoses are uniquely problematic.
authors.affiliation: Department of Psychology, University of Alabama, Tuscaloosa, AL 35487, USA. jchamilt@as.ua.edu
authors.forename: James C
authors.initials: JC
authors.lastname: Hamilton
authors.forename: Melike
authors.initials: M
authors.lastname: Eger
authors.forename: Saman
authors.initials: S
authors.lastname: Razzak
authors.forename: Marc D
authors.initials: MD
authors.lastname: Feldman
authors.forename: Natalie
authors.initials: N
authors.lastname: Hallmark
authors.forename: Stephen
authors.initials: S
authors.lastname: Cheek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001291:Attitude of Health Personnel; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005162:Factitious Disorders / Q000175:diagnosis / Q000453:epidemiology*; D019538:Health Care Surveys; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult