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New diagnostic scheme DSM 5
The diagnosis of somatoform disorder in DSM-4 has been replaced with somatic symptom disorder (SSD) in DSM-5. What is the difference?
The new diagnostic scheme focuses on the presence of symptoms and the excessive distress and abnormal/maladaptive emotional, cognitive, and behavioral responses to the symptoms rather than the absence of a medical explanation.
Indeed, SSD is highly comorbid with medical disorders (DSM-5, p 309). As an example, patients with known neuropathologically based movement disorders commonly also have conversion disorder (functional neurologic disorder) features/symptoms (altered sensory or motor function incompatible with known neurologic disorders)—these are not mutually exclusive.
Sources
- Lichter DG: Frontal-subcortical circuits. In Arciniegas DB, Anderson CA, Filley CM (eds): Behavioral neurology & neuropsychiatry. New York: Cambridge University Press, 2013, p 69.
- Greist JH, Jefferson JW: Obsessive-compulsive disorder. In Gabbard GO (ed): Gabbard’s treatments of psychiatric disorders. Washington, DC: American Psychiatric Publishing, 2014, pp 409-410.
- Youngner CG, Rothbaum BO, Friedman MJ: Posttraumatic stress disorder. In Gabbard GO (ed): Gabbard’s treatments of psychiatric disorders. Washington, DC: American Psychiatric Publishing, 2014, pp 479-503.
- Flaherty A, Ivkovic A: Movement disorders. In Stern TA, Fava M, Wilens TE, Rosenbaum JF (eds): Massachusetts General Hospital comprehensive clinical psychiatry. London: Elsevier, 2016, pp 871-882.
