Dx Revision Watch
Suzy Chapman Owner of Dx Revision Watch
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...So they want to move CFS in WHO to where the classification for somatic distress and dissociative disorders is? so to get a better system for these disorders?
Im not sure if Ive taken that sentence in the right way or not..but it is one of the ways in what has been said can be taken.
Note that the EACLPP has recently merged with the ECPR:
"The European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) and the European Network of Psychosomatic Medicine (ECPR) have recently merged the two associations to create a new society – the European Association of Psychosomatic Medicine (EAPM)"
Yes, that is what Creed, Fink and colleagues would like to see - a new category - Bodily distress disorder/bodily distress syndrome in what was the Somatoform Disorders section of ICD-10 that would capture IBS, FM, CFS, CF and a number of other illnesses/conditions.
According to Fink and colleagues, Bodily distress disorder/Bodily distress syndrome is a unifying diagnosis that encompasses somatization disorder, so-called “medically unexplained symptoms” (MUS), fibromyalgia, irritable bowel syndrome and chronic fatigue syndrome and some other conditions which they consider to be closely related, with a likely shared underlying aetiology but expressed through various body systems.
The ICD-11 Beta draft has already proposed to change the name of the Somatoform Disorders to Bodily distress disorders. Six existing ICD-10 legacy categories have been removed and there are three severities of Bodily distress disorder. But these three new categories have yet to be defined and described.
It may be the case that ICD-11 Revision is waiting on the outcome of field trials for the Primary Care version of ICD-11 (ICD-11-PHC) before committing to proposing definitions, disorder descriptions etc for these three proposed new categories for the main ICD-11 classification.
See:
Proposed new diagnoses of anxious depression and bodily stress syndrome in ICD-11-PHC: an international focus group study. [JOURNAL ARTICLE]
Full text, subscription required:
Family Practice (2012) doi: 10.1093/fampra/cms037
First published online: July 28, 2012
http://fampra.oxfordjournals.org/content/early/2012/07/20/fampra.cms037.long
[URL='http://fampra.oxfordjournals.org/content/early/2012/07/20/fampra.cms037.full.pdf+html'][URL='http://fampra.oxfordjournals.org/content/early/2012/07/20/fampra.cms037.full.pdf+html']http://fampra.oxfordjournals.org/content/early/2012/07/20/fampra.cms037.full.pdf html[/URL][/URL]
Abstract
http://www.ncbi.nlm.nih.gov/pubmed/22843638
The paper describes three BSS (Bodily Stress Disorder) symptom patterns and lists examples of
cardiopulmonary arousal
gastrointestinal arousal
musculoskeletal tension (including muscular and joint pain)
and examples of general unspecific symptoms such as concentration difficulties, impairment of memory, excessive fatigue, headache, dizziness.
The model is the "autonomic arousal model".
The paper says that although the conceptualization of BSS as a condition related to "autonomic hyperarousal" is not yet proven, the concept provides "a plausible theoretical model and a positive way to talk with patients about their condition."
See the Per Fink slide presentation on my site and also compare with the TERM and Reattribution Models that Goldberg, Fink and Rosendal were involved in developing.
Caveat: the proposals for ICD-11 and ICD-11-PHC are draft proposals and subject to change following field trial evaluation and may not survive the field trials or gain approval of ICD Revision Steering Group and the WHO Geneva classification experts to whom the consultation and sub working groups report.
Bear in mind also that for ICD-11, current proposals appear to be:
for CFS to become the Chapter 6 (Neurology chapter) ICD-11 Title category;
with (B)ME specified as an Inclusion term to CFS;
and PVFS listed under synonyms to CFS.
IBS has its own classification outside of Chapter 5 (Mental and behavioural disorders) as does FM.