The Concepts of Somatoform Disorders and Psychosomatic Diseases in ICD-10 and DSM-IV

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doi:10.15064/jjpm.37.1_21

This paper introduces changes in the concepts of somatoform disorders and psychosomatic diseases using the international disease classification systems of ICD-10 and DSM -IV, which are the most widely used at present. Since these two systems were developed for different purposes, it is expected that it will take a long time before there is complete agreement between them, in spite of an attempt to incorporate one system into the other. In this paper, similarities and differences in the diagnosis of the above disorders between the two systems are discussed in detail. International frequencies of related disorders are also discussed. For the Japanese data, frequencies for those disorders identified in the outpatient clinics of internal medicine, obtained in our WHO collaborative study are presented. According to judgements made by psychiatrists, of those patients who attended the outpatient clinics of internal medicine in Nagasaki, about 15% had some kind of psychiatric problems. Major disorders seen included general anxiety disorder, neurasthenia and depression spectrum disorders. Somatoform disorders, although observed, were not common. It also was clear that recognition of mental disorders differed greatly between physicians and psychiatrists. Of those patients who were diagnosed as having depression by physicians, one fourth were diagnosed as being normal and another fourth as having somatoform disorders by the psychiatrists. In this paper, I suggest that such diagnostic disagreements should be openly discussed and resolved in the Society, in which specialists from the various fields gather.

The Concepts of Somatoform Disorders and Psychosomatic Diseases in ICD-10 and DSM-IV

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