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Physical symptom disorder: A simpler diagnostic category for somatization-spectrum conditions

Kroenke, Kurt·2006·Journal of Psychosomatic Research

DOI 10.1016/j.jpsychores.2006.01.022

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Abstract

Objective To propose a simpler, more empiric, and patient-centered category for classifying physical symptoms that are "etiologically neutral," that is, not reliant on the assumption that symptoms that is poorly explained from a medical standpoint must de facto be psychological in origin.Methods Theoretical analysis, narrative review, and proposal.Results Studies have revealed several limitations in the current classification of somatoform disorders, including the poor reliability of lifetime symptom recall, the difficulty in adjudicating physical versus psychological explanations, and the stigma in assigning patients with medically unexplained symptoms to an Axis I psychiatric disorder. Physical symptom disorder (PSD) is proposed as a diagnostic category that would reside on Axis III (rather than Axis I) and replace somatization disorder, undifferentiated somatoform disorder, and pain disorder. PSD would consist of one or more physical symptoms currently present, not fully explainable by another medical or psychiatric disorder (with the exception of functional somatic syndromes), causing functional impairment. Duration must be at least 6 months, and severity could be graded as mild, moderate, or severe using a 15-symptom checklist (PHQ-15). Finally, the type of symptoms or symptom syndromes present in the patient could be specified.Conclusions PSD should be considered as a simpler and more inclusive diagnosis to replace several somatoform diagnoses currently in use.

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Authors: Kroenke, K.
Affiliations: Regenstrief Institute (US)
Corresponding author: Kroenke, Kurt
ORCID: Kroenke, Kurt
Venue: Journal of Psychosomatic Research
Publisher: Elsevier BV
Published: 2006-04
Volume: 60
Issue: 4
Pages: 335-339
ISSN: 0022-3999 (ISSN-L)
DOI: 10.1016/j.jpsychores.2006.01.022
OpenAlex: W2051975061
Cited by: 132
References: 30
Citations by year: 2026: 1 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 5 · 2013: 6 · 2012: 8
FWCI: 10.19
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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 › Fibromyalgia and Chronic Fatigue Syndrome Research
Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
Keywords: somatization, somatoform disorders, diagnostic classification, medically unexplained symptoms, somatization disorder, undifferentiated somatoform disorder, pain disorders, PHQ-15, functional disability, stigma
MeSH terms: Affective Symptoms, Terminology as Topic, Somatoform Disorders, World Health Organization, Reproducibility of Results, Prevalence

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Physical symptom disorder: A simpler diagnostic category for somatization-spectrum conditions

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