Somatoform disorders and rheumatic diseases: From DSM-IV to DSM-V

Alessandra Alciati, F. Atzeni, P. Sgiarovello, P. Sarzi-Puttini

Research output: Contribution to journalArticlepeer-review


Medically unexplained symptoms are considered 'somatoform disorders' in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The introduction of this nosographic category has been helpful in drawing attention to a previously neglected area, but has not been successful in promoting an understanding of the disorders' biological basis and treatment implications, probably because of a series of diagnostic shortcomings. The newly proposed DSM-V diagnostic criteria try to overcome the limitations of the DSM-IV definition, which was organised centrally around the concept of medically unexplained symptoms, by emphasising the extent to which a patient's thoughts, feelings and behaviours concerning their somatic symptoms are disproportionate or excessive. This change is supported by a growing body of evidence showing that psychological and behavioural features play a major role in causing patient disability and maintaining high level of health care use. Pain disorders is the sub-category of DSM-IV somatoform disorders that most closely resembles fibromyalgia. Regardless of the diagnostic changes recently brought about by DSM-V, neuroimaging studies have identified important components of the mental processes associated with a DSM- IV diagnosis of pain disorder.

Original languageEnglish
Pages (from-to)98-102
Number of pages5
Issue number1
Publication statusPublished - 2014


  • Fibromyalgia
  • Pain disorders
  • Statistical manual of mental disorders

ASJC Scopus subject areas

  • Rheumatology
  • Medicine(all)


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