Somatoform disorders and rheumatic diseases: from DSM-IV to DSM-V

  • A. Alciati | alessandra.alciati@libero.it Hermanas Hospitalarias, FoRiPsi, Dipartimento di Neuroscience Cliniche, Villa San Benedetto Menni, Albese con Cassano, Como, Italy.
  • F. Atzeni U.O. di Reumatologia, Ospedale Universitario L. Sacco, Milan, Italy.
  • P. Sgiarovello U.O. di Reumatologia, Ospedale Universitario L. Sacco, Milan, Italy.
  • P. Sarzi-Puttini U.O. di Reumatologia, Ospedale Universitario L. Sacco, Milan, Italy.

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.

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Published
2014-06-06
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Issue
Section
Reviews
Keywords:
Pain disorders, Statistical manual of mental disorders, Fibromyalgia.
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How to Cite
Alciati, A., Atzeni, F., Sgiarovello, P., & Sarzi-Puttini, P. (2014). Somatoform disorders and rheumatic diseases: from DSM-IV to DSM-V. Reumatismo, 66(1), 98-102. https://doi.org/10.4081/reumatismo.2014.770