چکیده (انگلیسی):

Background:Conceptualisation and classification of functional disorders appear highly inconsistent in the health-care
system, particularly in primary care. Numerous terms and overlapping diagnostic criteria are prevalent of which many
are considered stigmatising by general practitioners and patients. The lack of a clear concept challenges the general
practitioner’s decision-making when a diagnosis or a treatment approach must be selected for a patient with a
functional disorder. This calls for improvements of the diagnostic categories. Intense debate has risen in connection
with the release of the fifth version of the‘Diagnostic and Statistical Manual of Mental Disorders’ and the current
revision of the‘International Statistical Classification of Diseases and Related Health Problems’. We aim to discuss a new
evidence based diagnostic proposal, bodily distress syndrome, which holds the potential to change our current
approach to functional disorders in primary care. A special focus will be directed towards the validity and utility criteria
recommended for diagnostic categorisation.
Discussion:A growing body of evidence suggests that the numerous diagnoses for functional disorders listed in the
current classifications belong to one family of closely related disorders. We name the underlying phenomenon‘bodily
distress’; it manifests as patterns of multiple and disturbing bodily sensations. Bodily distress syndrome is a diagnostic
category with specific criteria covering this illness phenomenon. The category has been explored through empirical
studies, which in combination provide a sound basis for determining a symptom profile, the diagnostic stability and
the boundaries of the condition. However, as bodily distress syndrome embraces only the most common symptom
patterns, patients with few but impairing symptoms are not captured. Furthermore, the current lack of treatment
options may also influence the acceptance of the proposed diagnosis.
Summary:Bodily distress syndrome is a diagnostic category with notable validity according to empirical studies.
Nevertheless, knowledge is sparse on the utility in primary care. Future intervention studies should investigate the
translation of bodily distress syndrome into clinical practice. A particular focus should be directed towards the
acceptability among general practitioners and patients. Most importantly, it should be investigated whether the new
category may provide the basis for better treatment and improved clinical outcome.