DSM-5 SSD work group
This page of archived content is awaiting revision. Some links to DSM revision pages are no longer accessible on the APA’s website.
Somatic Symptom Disorders
The DSM-5 Work Group which this site monitored and which had the most relevance for “Chronic fatigue syndrome”, CFS, “CFS/ME”, IBS, FM, Chemical Sensitivity (CS), Chemical Injury (CI), EI, GWS and chronic Lyme disease patient communities was the Somatic Symptom Disorders Work Group (SSD WG), at one point also known as the Somatic Distress Disorders Work Group, which had responsibility for revision of the categories that were classified under Somatoform Disorders in DSM-IV.
The equivalent section in ICD-10 is Somatoform Disorders classified in ICD-10 Chapter V: Mental and Behavioural Disorders between codes F45 – F48.0.
Chronic fatigue syndrome was not categorized in DSM-IV and neither was Neurasthenia (ICD-10: Chapter V at F48.0). (Note that for the US specific, clinical modification of ICD-10, ICD-10-CM, Neurasthenia is coded at F48.8.)
Within the field of liaison psychiatry and psychosomatics, CFS, CFS/ME, IBS, FM, CI, CS, EI and a number of other conditions, for example, chronic Lyme disease, are bundled under the so-called “Functional Somatic Syndromes” (FSS) and “Medically Unexplained Syndromes” (MUS) umbrellas.
According to some psychiatrists, these so-called “functional syndromes” would “fall into the [DSM-IV] somatoform disorders category given their phenomenology, unknown physical causes, absence of reliable markers, and the frequent coexistence of somatic and psychiatric symptoms.” [1]
1 Special Report: August 1, 2008: Humberto Marin, MD and Javier I. Escobar, MD Unexplained Physical Symptoms What’s a Psychiatrist to Do? Psychiatric Times. Vol. 25 No. 9
Somatic Symptom Disorders Work Group
The group was chaired by Joel E Dimsdale, MD, who was also a member of the DSM-5 Task Force.
Somatic Symptom Disorders Work Group
Dimsdale, Joel E., M.D.
Barsky III, Arthur J., M.D. *
Creed, Francis, M.D. *
Frasure-Smith, Nancy, Ph.D.
Irwin, Michael R., M.D.
Keefe, Francis J., Ph.D.
Lee, Sing, M.D.
Levenson, James L., M.D. *
Sharpe, Michael, M.D . *
Wulsin, Lawson R., M.D.
2006 Research Planning Conference: Somatic Presentations of Mental Disorders Symposium
In September 2006, in collaboration with WHO and NIH, the APA convened a diagnosis-related research planning conference focusing on “Somatic presentations of mental disorders”.
Twenty-eight international researchers were invited to participate – the eighth in a series of thirteen conferences convened by the APA between 2004 and 2008.
Amongst those presenting at the Beijing Symposium were: Ricardo Araya (Bristol, UK); Simon Wessely (KCL, London, UK); *Javier Escobar (New Jersey, US); *Richard Mayou (Oxford, UK); *Michael Sharpe (Edinburgh, UK); *Winfried Rief (Marburg, Germany), Norman Sartorius (WHO, Geneva, Switzerland) and *Kurt Kroenke (Indianapolis, US).
At the time, the five asterisked presenters were also members of the international CISSD (Conceptual Issues in Somatoform and Similar Disorders Project workgroup*, co-ordinated by Dr Richard Sykes, PhD, between 2003 and 2007, Principal administrator: Action for M.E., Principal collaborator: Professor Rachel Jenkins, Director, WHO Collaborating Center, Institute of Psychiatry, London. (Dr Sykes went on to work on the “MUPSS Project”, administered by the Institute of Psychiatry.)
Professor Kurt Kroenke and Professor Michael Sharpe served as the CISSD Project’s international and UK chairs. Javier Escobar was a member of the DSM Revision Task Force; Professor Michael Sharpe was a member of the Somatic Symptom Disorders Work Group.
*Conceptual Issues in Somatoform and Similar Disorders Project (CISSD), was an unofficial private project undertaken between 2003 and 2007, initiated and co-ordinated by Dr Richard Sykes, PhD, former Director of Westcare UK; Principal Administrators, Action for M.E. Four members of the CISSD Project workgroup, Michael Sharpe, Arthur Barsky, Francis Creed and James Levenson went on to serve as members of the DSM-5 Somatic Symptoms Disorders Work Group from 2007. A fifth member, Javier Escobar, was a member of the DSM-5 Task Force, the DSM-5 Psychiatric/General Medical Interface Study Group and served as Task Force liaison to the DSM-5 SSD Work Group.
Javier Escobar, MD, Director of the University of Medicine and Dentistry of New Jersey (UMDNJ) – Robert Wood Johnson Medical School (RWJMS) Medically Unexplained Physical Symptoms (MUPS) Research Center, which has been supported with over $4M in funding by the US National Institute of Mental Health (NIMH), was also a member of the DSM-5 Task Force. Dr Escobar served as Task Force liaison to the Somatic Symptom Disorders Work Group.
In November 2007, an Editorial and selected papers based on the Beijing Symposium presentations were published in: Psychosom Med 2007 69: 827-900. These are subscription papers, but summaries of the presentations and recommendations can be read on the APA’s DSM-5 Development pages. The Journal Editorial is free.
The monograph Somatic Presentations of Mental Disorders Refining the Research Agenda for DSM-V published by American Psychiatric Publishing Inc., summarises the proceedings of the 2006 Beijing Symposium and provides “a research landscape and literature resource for researchers and clinicians”. Edited by Joel E Dimsdale, MD, Yu Xin, MD, Arthur Kleinman, MD, Vikram Patel, PhD, William E Narrow, MD, MPH, Paul J Sirovatka, MS, and Darrel A Regier, MD, MPH. 2009 206 pages ISBN 9780890423424 Paperback.
This Google Books “Somatic Presentations of Mental Disorders Refining the Research Agenda for DSM-V” preview provides access to some chapters, including the papers by Professors Simon Wessely (Chapter 2, Page 9) and Javier Escobar and (Chapter 4, Page 41) resulting out of the Beijing Symposium presentations.
The revision process towards DSM-5 has spawned dozens of journal papers, editorials and conference presentations around the so-called “Somatoform Disorders”, and around the so-called “Functional Somatic Syndromes” and “Medically Unexplained Symptoms and Syndromes”.
The 28 member DSM-5 Task Force set up 13 Work Groups which met from late 2007 to undertake the revision of DSM-IV. According to a November ’09 DSM-5 Work Group presentation, there were 16 Work Groups, four study groups, a General Medical Interface Study Group and and a number of ad hoc subcommittees. Work Groups also drew on external advisers whose names were not disclosed by the APA.
This DSM-5 Development website page Somatic Symptom Disorders Work Group linked to biosketches and CIO disclosure information for each Somatic Symptom Disorders Work Group member.
Study Groups
“As development on DSM-5 progressed, the importance of addressing cross-cutting issues relevant to all of the disorder work groups became increasingly evident. As a result, six DSM-5 Study Groups were formed to address these universal topic areas. Please click on the links below to learn more about the study groups and their members.”
Psychiatric/General Medical Interface Study Group
“The Psychiatric/General Medical Interface Study Group is chaired by Lawson R. Wulsin, M.D. The study group is examining the link between general medical disorders and psychiatric disorders. Given that most patients with mental illnesses are seen by primary care physicians, the study group aims to ensure that DSM-5 meets the needs of general medical practitioners and not just specialty mental health clinicians. The group is also developing revision strategies for the forthcoming DSM-5-PC, which is intended to be used in primary care settings. The members of the Psychiatric/General Medical Interface Study Group are listed below.”
Psychiatric/General Medical Interface Study Group Members
Wulsin, Lawson R., M.D. [Ed: Member, Somatic Symptoms Disorders Work Group]
Dahl, Ronald E., M.D.
Dimsdale, Joel E., M.D. [Ed: Chair, Somatic Symptoms Disorders Work Group]
Escobar, Javier I., M.D. [Ed: Member, Task Force and Liaison to SSD WG]
Jeste, Dilip V., M.D.
Kaufmann, Walter E., M.D.
Kreipe, Richard E., M.D.
Petersen, Ronald, Ph.D., M.D.
Reynolds, Charles F., M.D.
Segraves, Taylor R., M.D., Ph.D.
Walsh, Timothy B., M.D.
Professionals within the field and some of those who had served on previous Task Forces criticised the APA for the infrequency of updates on the progress of the various Work Groups and for the lack of detail in the few reports that were issued.
There were two key documents associated with proposals as they had stood in May 2011 [these were revisions of the January 2010 versions. These documents were not revised for the May 2012 public review period.]
Disorder Descriptions: Disorder Descriptions May 04, 2011
Rationale/Validity: Rationale Document May 04, 2011
The third and final public review of DSM-5 proposals was held between May 2 – June 15 2012.
Related material:
In the January 2010, Volume 16, Issue 1 edition of Advances in Psychiatric Treatment there were two editorials and an article around ICD-11 and DSM-V (DSM-5) revision classificatory issues. Read Abstract for the Sartorius Editorial here
Adv. Psychiatr. Treat., Jan 2010; 16: 1.
FROM THE EDITOR
Joe Bouch: Classification
Advances in Psychiatric Treatment (2010) 16: 2-9. doi:10.1192/apt.bp.109.007138
Editorial: Norman Sartorius
Revision of the classification of mental disorders in ICD-11 and DSM-V: work in progress
dx revision watch 