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Are somatoform disorders ‘mental disorders’? A contribution to the current debate

Rief, Winfrieda; Isaac, Mohanb

Current Opinion in Psychiatry: March 2007 - Volume 20 - Issue 2 - p 143–146
doi: 10.1097/YCO.0b013e3280346999
Behavioural medicine: Edited by Winfried Rief and Mohan Isaac
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Purpose of review During the last 2 years, a debate has started over whether the somatoform symptoms/medically unexplained symptoms are wrongly placed under the category of mental disorders (section F in International classification of diseases-10 and in Diagnostic and statistical manual for mental disorders-IV).

Recent findings Most experts on medically unexplained symptoms agree that there is a substantial need for revision of the diagnoses of somatoform disorders. While some authors suggest moving the somatoform disorders from axis I to axis III, others suggest improving the classification of these syndromes on axis I, such as by using empirically derived criteria and by introducing psychological descriptors which justify the categorization as a mental disorder. In contrast to the situation when the last version of Diagnostic and statistical manual for mental disorders was published, new empirical data has shown some psychological and behavioural characteristics of patients with somatoform symptoms. These and other empirically founded approaches can be landmarks for the revision of this section in Diagnostic and statistical manual for mental disorders-V and International classification of diseases-11.

Summary The classification of somatoform disorders as ‘mental disorders’ could be justified if empirically founded psychological and behavioural characteristics are included into the classification process. Attention focusing, symptom catastrophizing, and symptom expectation are outlined as possible examples of involved psychological processes.

aClinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany

bUniversity of Western Australia, Perth, Australia

Correspondence to Professor Dr Winfried Rief, PhD, University of Marburg, Clinical Psychology and Psychotherapy, Gutenbergstraβe 18, 35032 Marburg, Germany fax: +49 6421 2828904; e-mail: rief@staff.uni-marburg.de

© 2007 Lippincott Williams & Wilkins, Inc.