TY - JOUR
KW - Humans
KW - Patient Care Team
KW - Primary Health Care
KW - Psychiatry
KW - Psychophysiologic Disorders/classification/diagnosis/psychology
KW - Referral and Consultation
KW - Somatoform Disorders/classification/diagnosis/psychology
AU - P. Fink
AU - M. Rosendal
AU - F. Olesen
A1 - 
AB - OBJECTIVE: A substantial proportion of patients found in primary care complain of physical symptoms not attributable to any known conventionally defined disorder, that is, medically unexplained or functional somatic symptoms. The objective of this paper is to outline the problems with the current classification and propose a classification more suitable for primary health care. METHOD: We refer to and discuss relevant literature including papers on our own research on the topic in the light of our experiences from major projects on somatizing patients in primary health care. RESULTS: Functional somatic symptoms may impose severe suffering on the patient and are costly for society because of high health-care utilization, lost working years and social expenses. At present, studies on functional somatic symptoms and disorders and their treatment are hampered by lack of a valid and reliable diagnostic classification. The diagnostic categories of somatoform disorders are overlapping. Thus, the present situation is that patients with identical symptoms and clinical pictures may receive different diagnostic labels depending on the focus of interests of the assessing physician. A particular problem in primary care is that the somatoform diagnostic categories only include persistent cases and do not offer the opportunity for classification of the patients with short-symptom duration found in this setting. We present a framework for a new descriptive classification of functional somatic symptoms and unfounded illness worrying, and outline a new classification that covers the whole spectrum of severity seen in clinical practice. CONCLUSION: A precondition for an appropriate management of patients with functional somatic symptoms is a valid taxonomy common for all medical specialties facilitating cooperative care. Classification systems as outlined in this paper may be a candidate for such a system, but it should be subject to further evaluation in research.
BT - The Australian and New Zealand Journal of Psychiatry
C5 - Medically Unexplained Symptoms
CP - 9
CY - Australia
DO - 10.1111/j.1440-1614.2005.01682.x
IS - 9
JF - The Australian and New Zealand Journal of Psychiatry
N2 - OBJECTIVE: A substantial proportion of patients found in primary care complain of physical symptoms not attributable to any known conventionally defined disorder, that is, medically unexplained or functional somatic symptoms. The objective of this paper is to outline the problems with the current classification and propose a classification more suitable for primary health care. METHOD: We refer to and discuss relevant literature including papers on our own research on the topic in the light of our experiences from major projects on somatizing patients in primary health care. RESULTS: Functional somatic symptoms may impose severe suffering on the patient and are costly for society because of high health-care utilization, lost working years and social expenses. At present, studies on functional somatic symptoms and disorders and their treatment are hampered by lack of a valid and reliable diagnostic classification. The diagnostic categories of somatoform disorders are overlapping. Thus, the present situation is that patients with identical symptoms and clinical pictures may receive different diagnostic labels depending on the focus of interests of the assessing physician. A particular problem in primary care is that the somatoform diagnostic categories only include persistent cases and do not offer the opportunity for classification of the patients with short-symptom duration found in this setting. We present a framework for a new descriptive classification of functional somatic symptoms and unfounded illness worrying, and outline a new classification that covers the whole spectrum of severity seen in clinical practice. CONCLUSION: A precondition for an appropriate management of patients with functional somatic symptoms is a valid taxonomy common for all medical specialties facilitating cooperative care. Classification systems as outlined in this paper may be a candidate for such a system, but it should be subject to further evaluation in research.
PP - Australia
PY - 2005
SN - 0004-8674; 0004-8674
SP - 772
EP - 781
EP - 
T1 - Classification of somatization and functional somatic symptoms in primary care
T2 - The Australian and New Zealand Journal of Psychiatry
TI - Classification of somatization and functional somatic symptoms in primary care
U1 - Medically Unexplained Symptoms
U2 - 16168035
U3 - 10.1111/j.1440-1614.2005.01682.x
VL - 39
VO - 0004-8674; 0004-8674
Y1 - 2005
ER -