The somatoform disorders are a major diagnostic class in the diagnostic and statistical manual of mental disorders, fourth edition, text revision (DSM IV) which groups together conditions characterized by physical symptoms suggestive of but not fully explained by general medical or the direct effects of a substance. In this class symptoms are not intentionally produced and are not attributable to another mental disorder. The disorders included in this class are somatization disorder, conversion disorder, pain disorder, hypochondiasis, undifferentiated somatoform disorder, body dysmorphic disorder and somatoform disorder not otherwise specified (First &Allan Tasman 2010).
There appear to be sufficient reasons to group together the disorders mainly characterized by medically unexplained somatic symptoms; the predominance of such symptoms is a sufficient basis for the grouping of these disorders but it is still debated as to how these disorders are to be conceptualized, named, and classified. Because there is general dissatisfaction with the current conceptualization and classification of somatoform disorders, debate on the future of these conditions is much needed. The collaboration between psychiatrists and nonpsychiatric physicians is crucial in this debate, with the ultimate goal being adoption of a system that would be uniform and acceptable to all Vladan Starcevic, (2006).
For instance, Mayou et al. (2005) disagree with the current classification and overall concept of somatoform disorders. Among others, their criticisms include that the category is a “speculative category” with unproven validity, that psychological reaction to functional symptoms are classified differently from psychological reaction to physical disease w...
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...s, including when the symptoms are amplified by vicious circles beyond the original peripheral signal intensity. Cultural models of causal attributions of symptoms are powerful contributors in this regard; they set up expectations of the symptoms’ etiology and course. According to Kirkmayer and Sartorius (2007) Analysis of illness narratives collected from diverse ethnocultural groups suggests that somatic symptoms are located in multiple systems of meaning that serve diverse psychological and social functions. Depending on circumstances, these symptoms can be seen as an index of disease or disorder, an indication of psychopathology, a symbolic condensation of intrapsychic conflict, a culturally coded expression of distress, a medium for expressing social discontent, and a mechanism through which patients attempt to reposition themselves within their local worlds.
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