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Psychology Today Blog, by Allen Frances
Bad News: DSM 5 Refuses to Correct Somatic Symptom Disorder
It's quite a long piece and its not fair for me to quote it all, but a couple of his suggestions for change stood out for me, given some of the issues that are often raised about CFS:
Bad News: DSM 5 Refuses to Correct Somatic Symptom Disorder
Many of you will have read a previous blog prepared by Suzy Chapman and me that contained alarming information about the new DSM 5 diagnosis 'Somatic Symptom Disorder.'
SSD is defined so over inclusively by DSM 5 that it will mislabel 1 in 6 people with cancer and heart disease; 1 in 4 with irritable bowel and fibromyalgia; and 1 in 14 who are not even medically ill.
I hoped to be able to influence the DSM 5 work group to correct this in two ways: 1) by suggesting improvements in the wording of the SSD criteria set that would reduce mislabeling; and 2) by letting them know how much opposition they would face from concerned professionals and an outraged public if DSM 5 failed to slam on the brakes while there was still time
It's quite a long piece and its not fair for me to quote it all, but a couple of his suggestions for change stood out for me, given some of the issues that are often raised about CFS:
[his proposed and rejected] new criteria set would have made it much clearer that the person's concern about physical symptoms had to be 'excessive', 'maladaptive', 'pervasive', 'persistent', 'intrusive', 'extremely anxiety provoking', 'disproportionate', and 'consuming enough time to cause significant disruption and impairment in daily life'.
And I also suggested adding these new items to the criteria set to reduce the most common sources of inappropriate over diagnosis of Somatic Symptom Disorder.
• 'If a diagnosed medical condition is present, the thoughts, feelings, and behaviors must be grossly in excess of what would be expected given the nature of the medical condition.'
• 'If no medical diagnosis has yet been made, a thorough medical work-up should be performed and be repeated again at suitable intervals to uncover possible medical conditions that may declare themselves with the passage of time.'