Three BMJ letters published in response to Somatic Symptom Disorder commentary

Three letters are published this week in response to Allen Frances’ BMJ commentary on ‘Somatic Symptom Disorder’

Post #237 Shortlink:

On March 19, BMJ published a commentary by Allen Frances, MD, with contribution from Suzy Chapman, in both the print and online editions, strongly opposing the inclusion of ‘Somatic Symptom Disorder’ in the forthcoming DSM-5:

The new somatic symptom disorder in DSM-5 risks mislabeling many people as mentally ill
This new condition suggested in the bible of mental health diagnoses lacks specificity, says Allen Frances

The opinion piece was also featured as US Editor’s Choice:

DSM-5 and the rough ride from approval to publication
Edward Davies, US news and features editor, BMJ

BMJ press released the commentary which was picked up by a number of international media sites including UK Times and Deborah Brauser for Medscape Medical News. To date, 31 Rapid Responses have been received.

Three letters (all US respondents) are printed in this week’s BMJ print edition (20 April 2013 Vol 346, Issue 7904). The letters are behind a paywall so I am giving links to the original BMJ Rapid Responses, with the caveat that responses may have been edited for the print edition:

New somatic symptom disorder in DSM-5

Helping to find the most accurate diagnosis

BMJ 2013; 346 doi: (Published 16 April 2013) BMJ 2013;346:f2228
Joel E Dimsdale, professor of psychiatry emeritus, Michael Sharpe, professor of psychiatry, Francis Creed, professor of psychiatry, DSM-5 Somatic Symptom Disorders work group  BMJ Rapid Response 20 March 2013

Guilty of diagnostic expansion

BMJ 2013; 346 doi: (Published 16 April 2013) BMJ 2013;346:f2254
James Phillips, psychiatrist, USA  BMJ Rapid Response 25 March 2013

A step in the wrong direction

BMJ 2013; 346 doi: (Published 16 April 2013) BMJ 2013;346:f2233
Steven A King, chair, DSM-IV and DSM-IV-TR pain disorders committees; Pain Management and Psychiatry, New York  BMJ Rapid Response 28 March 2013

Further reading:

Somatic Symptom Disorder could capture millions more under mental health diagnosis Suzy Chapman, May 26, 2012
Mislabeling Medical Illness As Mental Disorder Allen Frances, MD, Psychology Today, DSM 5 in Distress, December 8, 2012
Why Did DSM 5 Botch Somatic Symptom Disorder? Allen Frances, MD, Psychology Today, Saving Normal, February 6, 2013
New Psych Disorder Could Mislabel Sick as Mentally Ill Susan Donaldson James, ABC News, February 27, 2013
Dimsdale JE. Medically unexplained symptoms: a treacherous foundation for somatoform disorders? Psychiatr Clin North Am 2011;34:511-3. [PMID: 21889675]

American Psychiatric Association justifications for SSD:

APA Somatic Symptom Disorder Fact Sheet 
Somatic Chapter Drops Centrality Of Unexplained Medical Symptoms Psychiatric News, Mark Moran, March 1, 2013
Somatic Symptoms Criteria in DSM-5 Improve Diagnosis, Care David J Kupfer, MD, Chair, DSM-5 Task Force, defends the SSD construct, Huffington Post, February 8, 2013


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