The Classification of Somatoform Disorders in ICD-10

Summary

The recognition of somatoform disorders as a major group in ICD-10 probably reflects the development of liaison psychiatry, and also of psychiatry in primary care. The provision of descriptions of these disorders that can be used reliably between observers should be regarded as the essential first step in studies of their distribution both in hospital groups and in the community. The differences between ICD-10 and DSM-IV for this group of disorders are largely differences in arrangement rather than differences in concepts. This agreement is partly due to the use in both classifications of the wide concept “disorder”, which implies a retreat from the idea of a diagnosis which underlies the presenting complaints. In future studies it will be important to examine social and cross-cultural issues by involving medical anthropologists from the start. This is because some of these disorders can be viewed, at least in part, as disturbances of sick roles and illness behaviour. This raises the question of whether future experimental classifications should contain separate and specified sections for role disorders, psychiatric disorders and syndromes, and brain diseases.