Stability of somatoform symptoms--implications for classification.

OBJECTIVE

To investigate the stability of somatoform symptoms/disorders.

METHODS

A literature search was done to select studies reporting data on stability of medically unexplained physical symptoms.

RESULTS

Whereas individual symptoms vary over time, grouping symptoms into syndromes seems to create stable features. There are substantial problems with the use of lifetime diagnosis, favoring classification approaches that require only present state symptoms. Further, doctors' ratings that symptoms are "medically unexplained" is highly problematic and reduces interrater reliability. Misdiagnoses and overlooking of organic conditions are in the same range as for other psychiatric (and many organic) disorders; therefore, this does not seem to reduce the stability of the diagnoses of somatoform disorders.

CONCLUSIONS

These results indicate how the classification of somatoform disorders can be improved. Some new diagnostic criteria are suggested that could be considered in the revision of Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V).