On 2017 Jul 02, Suzy Chapman commented:

ICD-11 Beta draft: Rationale for Proposal for Deletion of proposed new category: Bodily distress disorder

March 8, 2017

Full text:

http://wp.me/pKrrB-4dc

References:

1 Creed F, Guthrie E, Fink P, Henningsen P, Rief W, Sharpe M, White P. Is there a better term than “medically unexplained symptoms”? J Psychosom Res. 2010 Jan;68(1):5-8. doi:10.1016/j.jpsychores.2009.09.004. [PMID: 20004295]

2 Fink P, Schröder A. One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. J Psychosom Res. 2010 May;68(5):415-26. [PMID: 20403500]

3 Creed F, Gureje O. Emerging themes in the revision of the classification of somatoform disorders. Int Rev Psychiatry. 2012 Dec;24(6):556-67. doi: 10.3109/09540261.2012.741063. [PMID: 23244611]

4 Gureje O, Reed GM. Bodily distress disorder in ICD-11: problems and prospects. World Psychiatry. 2016 Oct;15(3):291-292. doi: 10.1002/wps.20353. [PMID: 27717252]

5 American Psychiatric Association. (2013). Somatic Symptom and Related Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

6 Frances A, Chapman S. DSM-5 somatic symptom disorder mislabels medical illness as mental disorder. Aust N Z J Psychiatry. 2013 May;47(5):483-4. [PMID: 23653063]

7 Lam TP, Goldberg DP, Dowell AC, Fortes S, Mbatia JK, Minhas FA, Klinkman MS. Proposed new diagnoses of anxious depression and bodily stress syndrome in ICD-11-PHC: an international focus group study. Fam Pract. 2013 Feb;30(1):76-87. doi: 10.1093/fampra/cms037. Epub 2012 Jul 28. [PMID: 22843638]

8 Ivbijaro G, Goldberg D. Bodily distress syndrome (BDS): the evolution from medically unexplained symptoms (MUS). Ment Health Fam Med. 2013 Jun;10(2):63-4. [PMID: 24427171]

9 Goldberg DP, Reed GM, Robles R, Bobes J, Iglesias C, Fortes S, de Jesus Mari J, Lam TP, Minhas F, Razzaque B et al. Multiple somatic symptoms in primary care: A field study for ICD-11 PHC, WHO’s revised classification of mental disorders in primary care settings. J Psychosom Res. 2016 Dec;91:48-54. doi:10.1016/j.jpsychores.2016.10.002. Epub 2016 Oct 4. [PMID: 27894462]

10 Medically Unexplained Symptoms, Somatisation and Bodily Distress: Developing Better Clinical Services, Francis Creed, Peter Henningsen, Per Fink (Eds), Cambridge University Press, 2011.

11 Frances Creed and Per Fink. Presentations, Research Clinic for Functional Disorders Symposium, Aarhus University Hospital, May 15, 2014.

12 Rief W, Isaac M. The future of somatoform disorders: somatic symptom disorder, bodily distress disorder or functional syndromes? Curr Opin Psychiatry September 2014 – Volume 27 – Issue 5 – p315–319. [PMID: 25023885]

13 Chalder, T. An introduction to “medically unexplained” persistent physical symptoms. Presentation, Department of Psychological Medicine, King’s Health Partners, 2014. [Accessed 27 February 2017]

14 Schumacher S, Rief W, Klaus K, Brähler E, Mewes R. Medium- and long-term prognostic validity of competing classification proposals for the former somatoform disorders. Psychol Med. 2017 Feb 9:1-14. doi: 10.1017/S0033291717000149. [PMID: 28179046]

15 Fink P, Toft T, Hansen MS, Ornbol E, Olesen F. Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosom Med. 2007 Jan;69(1):30-9. [PMID: 17244846]

16 Carroll L. Alice’s Adventures in Wonderland. 1885. Macmillan.

On 2016 Dec 17, Suzy Chapman commented:

Firstly, it is to be welcomed that authors Gureje and Reed have published this progress report on the work of the ICD-11 Somatic Distress and Dissociative Disorders Working Group (S3DWG) in an open access journal. The revision of ICD cannot be described as a "transparent and inclusive" process when ICD revision Topic Advisory Groups and sub working groups publish progress reports and rationales for their proposals behind paywalls.

I note the paper discusses the S3DWG's rationale for not including the word "somatic" in the name it proposes for its prototype disorder.

There is, however, no discussion within the paper of the sub working group's rationale for proposing to use the disorder term "Bodily distress disorder (BDD)" when this term is already being used interchangeably in the literature [1-4] with "Bodily distress syndrome (BDS)" - a divergent construct and criteria set already operationalized in Denmark, in clinical and research settings [5].

Omission of consideration within this paper of the potential impact for maintaining construct integrity within and beyond ICD-11 is troubling.

The S3DWG's "Bodily distress disorder" construct, as defined for the ICD-11 core version, has strong conceptual congruency and characterization alignment with DSM-5's "Somatic symptom disorder (SSD)" and poor conceptual and characterization alignment with Fink et al (2010) "Bodily distress syndrome."

It is noted that "Somatic symptom disorder" is also inserted into the ICD-11 Beta draft under Synonyms for BDD.

In sum:

ICD-11's proposed BDD is more closely aligned with DSM-5's SSD (Gureje and Reed, 2016).

The term "BDD" is already used interchangeably in the field for the operationalized "BDS" disorder construct [1-4].

That DSM-5's SSD and Fink et al's (2010) BDS are "very different" concepts, with different criteria sets, capturing different patient populations has been acknowledged by SSD work group chair, Joel E Dimsdale, and by Per Fink, Peter Henningsen and Francis Creed [6][7].

The unsoundness of introducing into ICD a new disorder category that proposes to use terminology that is already closely associated with a different (and already operationalized) construct/criteria set and the potential for conflation between the two has yet to be acknowledged or addressed by the sub working group responsible for this recommendation.

The S3DWG's choice of nomenclature needs referral back to the ICD-11 Revision Steering Group (RSG) and Joint Task Force (JTF) for urgent consideration of the implications of this proposed name for disorder integrity.

References:

1 An introduction to "medically unexplained" persistent physical symptoms, Presentation, Professor Trudie Chalder, Department of Psychological Medicine, King’s Health Partners, 2014, Slide #3 http://www.kcl.ac.uk/ioppn/depts/pm/research/imparts/Quick-links/Seminar-Slides/Seminar-7/Trudie-Chalder-intro.pdf

2 Rief W, Isaac M. The future of somatoform disorders: somatic symptom disorder, bodily distress disorder or functional syndromes? Curr Opin Psychiatry September 2014 - Volume 27 - Issue 5 - p 315–319 Rief W, 2014

3 Ivbijaro G, Goldberg D. Bodily distress syndrome (BDS): the evolution from medically unexplained symptoms (MUS). Ment Health Fam Med. 2013 Jun;10(2):63-4. Ivbijaro G, 2013

4 Fink P, Toft T, Hansen MS, Ornbol E, Olesen F. Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosom Med. 2007 Jan;69(1):30-9. Fink P, 2007

5 Fink P, Schröder A. One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. J Psychosom Res. 2010 May;68(5):415-26. Fink P, 2010

6 Medically Unexplained Symptoms, Somatisation and Bodily Distress: Developing Better Clinical Services, Francis Creed, Peter Henningsen, Per Fink (Eds), Cambridge University Press, 2011

7 Francis Creed and Per Fink. Presentations, Research Clinic for Functional Disorders Symposium, Aarhus University Hospital, May 15, 2014.

On 2016 Dec 17, Suzy Chapman commented:

Firstly, it is to be welcomed that authors Gureje and Reed have published this progress report on the work of the ICD-11 Somatic Distress and Dissociative Disorders Working Group (S3DWG) in an open access journal. The revision of ICD cannot be described as a "transparent and inclusive" process when ICD revision Topic Advisory Groups and sub working groups publish progress reports and rationales for their proposals behind paywalls.

I note the paper discusses the S3DWG's rationale for not including the word "somatic" in the name it proposes for its prototype disorder.

There is, however, no discussion within the paper of the sub working group's rationale for proposing to use the disorder term "Bodily distress disorder (BDD)" when this term is already being used interchangeably in the literature [1-4] with "Bodily distress syndrome (BDS)" - a divergent construct and criteria set already operationalized in Denmark, in clinical and research settings [5].

Omission of consideration within this paper of the potential impact for maintaining construct integrity within and beyond ICD-11 is troubling.

The S3DWG's "Bodily distress disorder" construct, as defined for the ICD-11 core version, has strong conceptual congruency and characterization alignment with DSM-5's "Somatic symptom disorder (SSD)" and poor conceptual and characterization alignment with Fink et al (2010) "Bodily distress syndrome."

It is noted that "Somatic symptom disorder" is also inserted into the ICD-11 Beta draft under Synonyms for BDD.

In sum:

ICD-11's proposed BDD is more closely aligned with DSM-5's SSD (Gureje and Reed, 2016).

The term "BDD" is already used interchangeably in the field for the operationalized "BDS" disorder construct [1-4].

That DSM-5's SSD and Fink et al's (2010) BDS are "very different" concepts, with different criteria sets, capturing different patient populations has been acknowledged by SSD work group chair, Joel E Dimsdale, and by Per Fink, Peter Henningsen and Francis Creed [6][7].

The unsoundness of introducing into ICD a new disorder category that proposes to use terminology that is already closely associated with a different (and already operationalized) construct/criteria set and the potential for conflation between the two has yet to be acknowledged or addressed by the sub working group responsible for this recommendation.

The S3DWG's choice of nomenclature needs referral back to the ICD-11 Revision Steering Group (RSG) and Joint Task Force (JTF) for urgent consideration of the implications of this proposed name for disorder integrity.

References:

1 An introduction to "medically unexplained" persistent physical symptoms, Presentation, Professor Trudie Chalder, Department of Psychological Medicine, King’s Health Partners, 2014, Slide #3 http://www.kcl.ac.uk/ioppn/depts/pm/research/imparts/Quick-links/Seminar-Slides/Seminar-7/Trudie-Chalder-intro.pdf

2 Rief W, Isaac M. The future of somatoform disorders: somatic symptom disorder, bodily distress disorder or functional syndromes? Curr Opin Psychiatry September 2014 - Volume 27 - Issue 5 - p 315–319 Rief W, 2014

3 Ivbijaro G, Goldberg D. Bodily distress syndrome (BDS): the evolution from medically unexplained symptoms (MUS). Ment Health Fam Med. 2013 Jun;10(2):63-4. Ivbijaro G, 2013

4 Fink P, Toft T, Hansen MS, Ornbol E, Olesen F. Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosom Med. 2007 Jan;69(1):30-9. Fink P, 2007

5 Fink P, Schröder A. One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. J Psychosom Res. 2010 May;68(5):415-26. Fink P, 2010

6 Medically Unexplained Symptoms, Somatisation and Bodily Distress: Developing Better Clinical Services, Francis Creed, Peter Henningsen, Per Fink (Eds), Cambridge University Press, 2011

7 Francis Creed and Per Fink. Presentations, Research Clinic for Functional Disorders Symposium, Aarhus University Hospital, May 15, 2014.