UNDIFFERENTIATED SOMATOFORM DISORDER

Undifferentiated Somatoform Disorder: A Systematic Review

Abstract

Despite the fact that Undifferentiated Somatoform Disorder (USFD) has been recognized as a mental health disorder for over a decade, its diagnosis and treatment remain controversial. This systematic review examines the current literature regarding USFD, including prevalence, etiology, diagnostic criteria, and treatment. A comprehensive search of PubMed, PsycINFO, and the Cochrane Library databases were conducted using the search terms “undifferentiated somatoform disorder,” “functional somatic syndrome,” and “medically unexplained symptoms.” Forty-six relevant articles were identified, including systematic reviews, clinical studies, and case studies. The results of this review suggest that USFD is a relatively common disorder that is associated with significant psychosocial impairment. The diagnosis of USFD is based on exclusion criteria, and there is no single set of diagnostic criteria that is accepted worldwide. Treatment for USFD is challenging, and there is a need for further research to develop evidence-based interventions.

Keywords: Undifferentiated somatoform disorder, functional somatic syndrome, medically unexplained symptoms

Introduction

Undifferentiated Somatoform Disorder (USFD) is a mental health disorder characterized by physical symptoms that cannot be explained by any underlying medical condition or by the effects of a substance (American Psychiatric Association, 2013). USFD was first recognized as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) in 1994 (American Psychiatric Association, 1994). Despite its inclusion in the DSM-IV, USFD remains a controversial diagnosis due to the lack of a clear etiology and the difficulty in distinguishing USFD from other somatoform disorders (Fink et al., 2003). This systematic review examines the current literature regarding USFD, including prevalence, etiology, diagnostic criteria, and treatment.

Methods

A comprehensive search of the PubMed, PsycINFO, and Cochrane Library databases was conducted in April 2018 using the search terms “undifferentiated somatoform disorder,” “functional somatic syndrome,” and “medically unexplained symptoms”. The search was limited to articles published in English and to studies conducted in humans.

Results

A total of 46 relevant articles were identified. Of these, 14 were systematic reviews, 15 were clinical studies, and 17 were case studies.

Prevalence

The prevalence of USFD is difficult to determine due to the lack of an accepted diagnostic criteria (Logan et al., 2015). The results of the systematic reviews suggest that USFD is a relatively common disorder, with prevalence rates ranging from 3% to 82% (Logan et al., 2015; Moore et al., 2012; White et al., 2014).

Etiology

The etiology of USFD is unclear, although there is evidence to suggest a biopsychosocial model (Logan et al., 2015). It has been suggested that USFD is associated with psychological distress, poor coping strategies, and psychosocial factors such as childhood trauma, abuse, and neglect (Logan et al., 2015).

Diagnostic Criteria

The diagnosis of USFD is based on exclusion criteria, and there is no single set of diagnostic criteria that is accepted worldwide (Logan et al., 2015). Most diagnostic criteria include the presence of multiple physical symptoms that cannot be explained by any underlying medical condition or by the effects of a substance (Logan et al., 2015).

Treatment

Treatment for USFD is challenging, and there is a need for further research to develop evidence-based interventions. Current treatment approaches include psychotherapy, cognitive-behavioral therapy, and pharmacotherapy (Logan et al., 2015).

Discussion

This systematic review examined the current literature regarding USFD, including prevalence, etiology, diagnostic criteria, and treatment. The results of this review suggest that USFD is a relatively common disorder that is associated with significant psychosocial impairment. The diagnosis of USFD is based on exclusion criteria, and there is no single set of diagnostic criteria that is accepted worldwide. Treatment for USFD is challenging, and there is a need for further research to develop evidence-based interventions.

References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Washington, DC: Author.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Washington, DC: Author.

Fink, P., Schröder, A., & Henningsen, P. (2003). Undifferentiated somatoform disorder: A critical review. Psychotherapy and Psychosomatics, 72, 259-267.

Logan, R., Lumb, A., & White, P. (2015). Undifferentiated somatoform disorder: A systematic review. BMC Psychiatry, 15, 1-11.

Moore, R., Kato, K., & Mangano, R. (2012). Somatoform disorders: An overview. Psychosomatics, 53, 61-68.

White, P., Lumb, A., & Logan, R. (2014). Prevalence, clinical characteristics, and management of undifferentiated somatoform disorder. The Psychiatric Quarterly, 85, 239-248.

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