Bodily symptoms: New approaches to classification
Abstract
Objective To examine the current approach to classifying bodily symptoms in both psychiatry and medicine and to suggest better alternatives.Methods Theoretical analysis, narrative review, and theoretical proposal.Results The assumptions that (a) bodily pathology can always explain bodily symptoms, (b) psychopathology can always explain bodily symptoms in the absence of bodily pathology, and (c) dichotomizing bodily symptoms into "medical" and "psychiatric" types is clinically useful were all found to have questionable validity and utility.Conclusion Alternative multiaxial diagnostic approaches for the classification of bodily symptoms are proposed. These are intended to (a) give greater prominence to bodily symptoms in their own right, (b) allow etiology to be conceptualized in terms of multiple factors, and (c) provide the basis for integrating medical and psychiatric approaches to patient care.
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The shortcomings of the MUS category are the mind-body dualism present in the unreliable classification of complaints as medically explained or not and the random categorisation into different somatoform disorders.
“The shortcomings of the MUS category is the mind-body dualism present in the unreliable classification of complaints as medically explained or not (Creed 2009;Sharpe, Mayou & Walker, 2006) and the random categorisation into different somatoform disorders (Leiknes, Finset, Moum & Sandanger, 2006).”
From Clinical outcomes from The BodyMind Approach™ in the treatment of patients with medically unexplained symptoms in primary health care in England: Practice-based evidence (2016) · cites this paper as Sharpe et al., 2006
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- Authors
- Sharpe, M., Mayou, R., & Walker, J.
- Affiliations
- University of Edinburgh (GB)
- Warneford Hospital (GB)
- Corresponding author
- Sharpe, Michael
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2006-04
- Volume
- 60
- Issue
- 4
- Pages
- 353-356
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2121041896
- Cited by
- 87
- References
- 25
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2018: 1 · 2017: 4 · 2016: 1 · 2015: 2 · 2014: 2 · 2013: 6 · 2012: 9
- FWCI
- 7.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- somatic symptoms, symptom classification, psychosomatic medicine, psychiatric diagnosis, diagnosis, multiaxial classification
- MeSH terms
- Chronic Disease, Depressive Disorder, Diagnosis, Differential, Humans, Pain, Psychophysiologic Disorders, Diagnostic and Statistical Manual of Mental Disorders
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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