title: Somatoform disorders and rheumatic diseases: from DSM-IV to DSM-V.
abstract: Medically unexplained symptoms are considered 'somatoform disorders' in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The introduction of this nosographic category has been helpful in drawing attention to a previously neglected area, but has not been successful in promoting an understanding of the disorders' biological basis and treatment implications, probably because of a series of diagnostic shortcomings. The newly proposed DSM-V diagnostic criteria try to overcome the limitations of the DSM-IV definition, which was organised centrally around the concept of medically unexplained symptoms, by emphasising the extent to which a patient's thoughts, feelings and behaviours concerning their somatic symptoms are disproportionate or excessive. This change is supported by a growing body of evidence showing that psychological and behavioural features play a major role in causing patient disability and maintaining high level of health care use. Pain disorders is the sub-category of DSM-IV somatoform disorders that most closely resembles fibromyalgia. Regardless of the diagnostic changes recently brought about by DSM-V, neuroimaging studies have identified important components of the mental processes associated with a DSM- IV diagnosis of pain disorder.
authors.affiliation: Hermanas Hospitalarias, FoRiPsi, Dipartimento di Neuroscience Cliniche, Villa San Benedetto Menni, Albese con Cassano, Como. alessandra.alciati@libero.it.
authors.forename: A
authors.initials: A
authors.lastname: Alciati
authors.forename: F
authors.initials: F
authors.lastname: Atzeni
authors.forename: P
authors.initials: P
authors.lastname: Sgiarovello
authors.forename: P
authors.initials: P
authors.lastname: Sarzi-Puttini
mesh_terms: D059350:Chronic Pain / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005356:Fibromyalgia / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D059906:Neuroimaging; D010147:Pain Measurement; D058748:Pain Perception; D012216:Rheumatic Diseases / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D013001:Somatoform Disorders / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D063189:Symptom Assessment