Somatoform disorder

At a glance

• Persistent physical symptoms are among the commonest reasons for outpatient referral. Around a quarter to a third of new neurology and gastroenterology referrals have symptoms not explained by structural disease.
• DSM-5 replaced "somatoform disorders" and "medically unexplained" with somatic symptom disorder, defined by the patient's response to symptoms rather than the absence of a cause.
• The physician's jobs: assess proportionately, make positive diagnoses where they exist (functional neurological disorder, IBS, fibromyalgia), explain, and avoid iatrogenic harm.