Saturday, October 24, 2009

Is there a better term than "medically unexplained symptoms"?

From Suzy Chapman

24 October 2009

An Editorial to watch out for in a forthcoming issue of the Journal of
Psychosomatic Research.

The In Press version is already available online (purchase required).

[Current issue is Volume 67, Issue 5, Pages A1-A4, 367-466 (November 2009)]

Journal of Psychosomatic Research

In Press

Is there a better term than "Medically unexplained symptoms"?



Copyright © 2009 Published by Elsevier Inc.

References and further reading may be available for this article. To view
references and further reading you must purchase this article.


Francis Creed a, Elspeth Guthrie a, Per Fink b, Peter Henningsen c,
Winfried Rief d, Michael Sharpe e and Peter White f

a University of Manchester, Manchester, UK
b University Hospital Aarhus, Denmark
c Technical University, Munich Germany
d University of Marburg, Germany
e University of Edinburgh, UK
f Queen Mary University of London, UK

Received 24 August 2009; revised 24 August 2009; accepted 7 September 2009.
Available online 17 October 2009.

Article Outline


"Medically unexplained symptoms" - one advantage, but many reasons to
discontinue use of the term

Criteria to judge the value of alternative terms for "medically unexplained

Terms suggested as alternatives for "medically unexplained symptoms"

Implications for treatment

Implications for DSM-V and ICD-11





Francis Creed is Co-Editor of the Journal of Psychosomatic Research.

Francis Creed, Per Fink, Peter Henningsen and Winfried Rief were all
members of the international CISSD Project, (Principal Administrators:
Action for M.E., Co-ordinator: Dr Richard Sykes, now engaged in the "London
MUPSS Project" in association with the Institute of Psychiatry).
Michael Sharpe was the UK Chair of the CISSD Project.

Michael Sharpe and Francis Creed have been members of the APA's DSM-V
Somatic Distress Disorders Work Group since 2007.

Francis Creed (UK), Peter Henningsen (Germany) and Per Fink (Denmark) are
the co-ordinators of European EACLPP MUS Work Group.

Francis Creed and Peter Henningsen were the authors of "A white paper of
the EACLPP Medically Unexplained Symptoms study group - Patients with
medically unexplained symptoms and somatisation - a challenge for European
health care systems", January 2009.  Draft white paper here:

Per Fink is a member of the Danish Working Group on Chronic Fatigue
Syndrome, established in August 2008 and expected to complete its work in
spring 2009.

DSM-V is anticipated to be finalised in May 2012; field trials were
expected to start in October 2009.  No updates or reports have been
published by the APA's DSM-V Task Force or Work Groups since April 2009.

An Editorial: The proposed diagnosis of somatic symptom disorders in DSM-V
to replace somatoform disorders in DSM-IV - a preliminary report by DSM-V
Work Group members, Joel Dimsdale and Francis Creed on behalf of the DSM-V
Workgroup on Somatic Symptom Disorders. was published in the June 2009
issue of the Journal of Psychosomatic Research.

Full text of DSM-V WG preliminary report can be accessed here:

The International Advisory Group for the Revision of ICD-10 Mental and
Behavioural Disorders most recent meeting took place on 28 - 29 September.
It is anticipated that a Summary Report of the meeting will be available in
late November/December.

DSM-V and ICD-11 have committed as far as possible "to facilitate the
achievement of the highest possible extent of uniformity and harmonization
between ICD-11 mental and behavioural disorders and DSM-V disorders and
their diagnostic criteria" with the objective that "the WHO and APA should
make all attempts to ensure that in their core versions, the category
names, glossary descriptions and criteria are identical for ICD and DSM."

For detailed information on the proposed structure of ICD-11, the
Content Model and operation of iCAT, the collaborative authoring platform
through which the WHO will be revising ICD-10, please scrutinise key
documents on the ICD-11 Revision Google site:


Suzy Chapman
* * *
There are better terms, but you know doctors aren't going to agree to terms like "Doctor Lacks Adequate Knowledge".
It is much easier on their egos to blame the patient for having a couple screws loose than to admit the truth that "maybe I haven't figured out yet what's the right test for what you have".

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