Somatic Symptom Disorder

The DSM-5 Somatic Symptom Disorders Work Group is proposing to rename the Somatoform Disorders section of DSM-IV to “Somatic Symptom Disorders” and fold a number of existing categories into a single new disorder with a new definition and criteria.

The following DSM-IV categories: somatization disorder, hypochondriasis, pain disorder, and undifferentiated somatoform disorder are proposed to be replaced with a single new disorder called “Complex Somatic Symptom Disorder” or possibly “Somatic Symptom Disorder.”

The latest proposed category names for the revision of the “Somatoform Disorders” section of DSM now look like this:

Somatic Symptom Disorders

J 00 Somatic Symptom Disorder – with the option for specifying:

Mild Somatic Symptom Disorder
Moderate Somatic Symptom Disorder
Severe Somatic Symptom Disorder

J 01 Illness Anxiety Disorder |
J 02 Conversion Disorder (Functional Neurological Symptom Disorder) |
J 03 Psychological Factors Affecting Medical Condition |
J 04 Factitious Disorder |
J 05 Somatic Symptom Disorder Not Elsewhere Classified |

See this link on the DSM-5 Development site for the most recent proposed criteria:

J 00 Somatic Symptom Disorder 

Note that the criteria for CSSD in the previous draft, in May 2011, had required at least two from the B criteria:

B. Excessive thoughts, feelings, and behaviors related to these somatic symptoms or associated health concerns: At least two of the following must be present.”

(1) High level of health-related anxiety.
(2) Disproportionate and persistent concerns about the medical seriousness of one’s symptoms.
(3) Excessive time and energy devoted to these symptoms or health concerns.

But for the third draft, the requirement has been reduced to at least one from the B criteria:

B. Excessive thoughts, feelings, and behaviors related to these somatic symptoms or associated health concerns: At least one of the following must be present.

(1) Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
(2) Persistently high level of anxiety about health or symptoms
(3) Excessive time and energy devoted to these symptoms or health concerns

For the first and second stakeholder reviews, two PDF documents were published which expanded on the criteria and the Work Group’s rationales for their proposals. For this third review, no updated PDF documents have been issued. If PDFs are issued before the comment period closes, I will update.

The documents that had accompanied the second review can be read here but bear in mind that some revisions have been made to the criteria and proposals since May 2011, including to the CSSD/SSD criteria and that feedback should be based on criteria as currently set out on the DSM-5 Development website.

PDF Disorder Descriptions   May 04, 2011

PDF Rationale Document   May 04, 2011

Open the Rationale Tab on the page for J 00 Somatic Symptom Disorders for brief Rationale.

Why are these criteria problematic? Go to Page 2.