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Romanian Journal of Internal Medicine

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Evolution of Psychosomatic Diagnosis in DSM. Historical Perspectives and New Development for Internists

Ramona Moldovan / Mădălina Radu / Adriana Băban / D.L. Dumitraşcu
Published Online: 2015-10-07 | DOI: https://doi.org/10.1515/rjim-2015-0003


The so-called “Psychosomatic symptoms” represent a real challenge for internists. These have often been described as non-specific, non-organic, functional, dysfunctional or idiopathic. These “diagnostic puzzles” are obviously difficult to treat. Psychosomatic symptoms have been categorized as hysteria, psychogenic, psychosomatic, conversion, somatization and somatoform disorder. It is only when modern classificatory systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) were developed that research was stimulated and new clinical developments became much stronger than any other time. The current paper is aimed at briefly presenting the evolution of psychosomatic symptoms in DSM while pointing out the major milestones as well as the benefits and challenges along the way. We discuss the perspectives open with the advent of the 5th edition the DSM-V.


Aşa numitele „Simptome psihosomatice” reprezintă o provocare pentru internişti. Aceste simptome au fost frecvent descrise ca nespecifice, ne-organice, funcţionale, disfuncţionale sau idiopatice. Aceste „puzzles” diagnostice sunt desigur greu de tratat. Simptomele psihosomatice au fost categorizate ca isterie, psihogene, psihosomatice, tulburări de conversie, somatizare şi tulburări somatoforme. Sistemele moderne de clasificare precum Diagnostic and Statistical Manual (DSM) şi Clasificarea Internaţională a Maladiilor (CMI) au stimulat cercetarea şi au permis o mai pregnantă identificare clinică a acestor tulburări. Prezentul articol arată succint evoluţia simptomelor psihosomatice din perspectiva DSM, cu accent pe avantajele şi provocările acestui sistem de clasificare. Sunt discutate perspectivele deschise odată cu apariţia ediţiei a cincea a DSM, DSM-V.

Keywords: Diagnostic and Statistical Manual of Mental Disorders; psychosomatic symptoms


  • 1. SHEPHERD M, COOPER R, BROWN AC, KALTON GW (1966). Psychiatric illness in general practice. Oxford University Press, London.Google Scholar

  • 2. MAYOU R. Medically unexplained physical symptoms. Br Med J, 1991, 303, 534-35.Google Scholar

  • 3. OKEN D. Evolution of psychosomatic diagnosis in DSM. Psychosom Med, 2007, 69, 830-1.Web of ScienceGoogle Scholar

  • 4. VEIGH I. Hysteria: the history of a disease. University of Chicago Press, Chicago, 1965. Google Scholar

  • 5 BOSS JMN. The seventeenth century transformation of the hysteric affection, and Sydemham’s Baconiam medicine. Psychol Med, 1979, 9, 221-34. Google Scholar

  • 6 KALLIVAYALIL RA & PUNNOOSE VP, Understanding and managing somatoform disorders: Making sense of non-sense.Indian J Psychiatry, 2010, 52, 240-245.Google Scholar

  • 7. JANA AK & PRAHARAJ SK & MAZUMDAR J. Current debates over nosology of somatoform disorders. Ind Psychiatry, 2012, 21, 4-10.Google Scholar

  • 8. LIPOWSKI ZJ. Somatization: The concept and its clinical application. Am J Psychiat, 1988, 145, 1358-68.Google Scholar

  • 9. HINSIE LE & CAMPBELL RJ. Psychiatric dictionary, Oxford University Press, New York, 1960.Google Scholar

  • 10. FAVA GA, SONINO N. The clinical domains of psychosomatics medicine. J Clin Psychiatry, 2005, 66, 849-58.Google Scholar

  • 11. GITLIN DF, LEVENSON JL, LYKETSOS CG. Psychosomatic medicine: a new psychiatric subspecialty. Acad Psychiatry, 2004, 28, 4-11.Google Scholar

  • 12. BĂBAN A, DUMITRAŞCU DL. Somatisation: a modern concept for a classic clinical syndrome, Journal of of Medical Life, 1991, 8.Google Scholar

  • 13. DIMSDALE JE, XIN Y, KLEINMAN A, PATEL V, NARROW WE, SIROVATKA PJ, REGIER DA. Somatic Presentations of mental disorders: refining the research agenda for DSM-5. Arlington VA: American Psychiatric Association, 2009.Google Scholar

  • 14. FINK P. Somatization disorder and related disorders. In: GELDER MG, LOPEZ-IBOR JJ, ANDREASEN NC, editors. New Oxford Textbook of Psychiatry. New York: Oxford University Press, 2000.Google Scholar

  • 15. HILLER W, RIEF W. Why DSM-III was right to introduce the concept of somatoform disorders. Psychosomatics, 2005, 46, 105-8.Google Scholar

  • 16. GHANIZADEH A, FIROOZABADI A. A review of somatoform disorders in DSM-IV and somatic symptom disorders in proposed DSM-V. Psychiatr Danub, 2012, 24, 353-8.Google Scholar

About the article

Received: 2015-02-10

Published Online: 2015-10-07

Published in Print: 2015-03-01

Citation Information: Romanian Journal Of Internal Medicine, Volume 53, Issue 1, Pages 27–32, ISSN (Online) 1220-4749, DOI: https://doi.org/10.1515/rjim-2015-0003.

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© 2015. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License. BY-NC-ND 4.0

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