title: Cenesthopathy in adolescence: an appraisal of diagnostic overlaps along the anxiety-hypochondriasis-psychosis spectrum.
abstract: OBJECTIVE
  To discuss the diagnostic validity of unusual bodily perceptions along the spectrum from age-specific, often transitory and normal, to pathological phenomena in adolescence to hypochondriasis and finally to psychosis.
  
  
  METHODS
  Critical literature review of the cornerstone diagnostic groups along the spectrum embracing anxiety and cenesthopathy in adolescence, hypochondriasis, and cenesthopathy and psychosis, followed by a discussion of the diagnostic overlaps along this spectrum.
  
  
  RESULTS
  The review highlights significant overlaps between the diagnostic cornerstones. It is apparent that adolescents with unusual bodily perceptions may conceptually qualify for more than one diagnostic group along the spectrum. To determine whether cenesthopathies in adolescence mirror emerging psychosis, a number of issues need to be considered, i.e. age and mode of onset, gender, level of functioning and drug use. The role of overvalued ideas at the border between hypochondriasis and psychosis must be considered.
  
  
  CONCLUSIONS
  As unusual bodily symptoms may in some instances meet formal psychosis risk criteria, a narrow understanding of these symptoms may lead to both inappropriate application of the new DSM-5 attenuated psychosis syndrome and of treatment selection. On the other hand, the possibility of a psychotic dimension of unusual bodily symptoms in adolescents must always be considered as most severe expression of the cenesthopathy spectrum.
authors.affiliation: Department of Psychiatry and Psychotherapy (UPK), University of Basel, Basel 4056, Switzerland; Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, 4101 Bruderholz, Switzerland; University Hospital of Psychiatry, University of Bern, 3010 Bern Switzerland. Electronic address: andor.simon@bluewin.ch.
authors.forename: Andor E
authors.initials: AE
authors.lastname: Simon
authors.affiliation: Department of Psychiatry and Psychotherapy (UPK), University of Basel, Basel 4056, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Borgwardt
authors.affiliation: Department of Psychiatry and Psychotherapy (UPK), University of Basel, Basel 4056, Switzerland.
authors.forename: Undine E
authors.initials: UE
authors.lastname: Lang
authors.affiliation: Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, 4101 Bruderholz, Switzerland.
authors.forename: Binia
authors.initials: B
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D006998:Hypochondriasis / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000473:pathology