I also find the statement:
Because ME/CFS and chronic Lyme disease are quintessential examples of MUS..."
unhelpful.
In 2018, the World Health Organization (WHO) chose to replace somatization with “bodily distress disorder” in the new general edition of the International Classification of Diseases (ICD-11) (Gureje and Reed 2016), while a different construct, “bodily stress syndrome,” has been recommended to fill the parallel slot in the new ICD for primary care (Goldberg et al. 2016).
Note that the publication referred to above as
"the new ICD for primary care" is the ICD-11 PHC*, which is still in development [1].
ICD-11 PHC is a clinical guideline written in simpler language intended to assist non-mental health specialists, especially primary care practitioners and non medically trained health workers with the diagnosis and management of common mental disorders. It is also intended for use in low resource settings and low- to middle-income countries where clinical facilities/access to trained diagnosticians are scarce or non existent.
The ICD-11 PHC is proposed to comprise 27 "common mental disorders" and contains no general medical diseases. Like the ICD-10 PHC (1996), this revised diagnostic and management guideline will not be mandatory for use by member states and the WHO intends to make the guideline available on its website as an unlicensed download.
If ICD-11 PHC goes forward with its proposed "Bodily Stress Syndrome" category, there will be all these diagnostic constructs and criteria sets in play:
Somatic symptom disorder (DSM-5; under BDD Synonyms list in the core ICD-11; potentially added to SNOMED CT)
Bodily distress disorder (core ICD-11; SNOMED CT)
Bodily Stress Syndrome (proposed for the ICD-11 PHC guideline for 27 common mental disorders)
Bodily distress syndrome (Fink et al 2010, operationalized in Denmark and beyond)
plus the existing ICD-10 and SNOMED CT Somatoform disorders categories and their equivalents in ICPC-2 (a primary care classification system that is available in over 30 countries and is mandatory for use in primary care in 6 EU countries, including the Netherlands).
I hope this clarifies that the forthcoming ICD-11 PHC is a non mandatory guideline for 27 mental disorders only and not an abridged version of all the chapters in the core ICD-11.
*The ICD-11 PHC has not been developed on a publicly accessible platform and the draft texts for the 27 mental disorders proposed to be included are not available for public stakeholder review and comment. There is no indication when the WHO expects to finalise and release the ICD-11 PHC.
1 Slide presentation:
MUS becomes Bodily Stress Syndrome in the ICD-11 for primary care, Marianne Rosendal (2017)
Note: The ICD-11 PHC should not be confused with the
Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders that has been developed by the WHO Department of Mental Health and Substance Abuse and is the equivalent of the ICD-10 "Blue Book".
The brief descriptive texts in
Chapter 06: Mental, behavioural or neurodevelopmental disorders in the core version of ICD-11 are intended for use by coders and clerical workers as a basis for statistical reporting.
The
Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders provides expanded clinical descriptions, essential (required) features, boundaries with other disorders and normality, differential diagnoses, additional features, culture-related features and codes for all mental and behavioural disorders commonly encountered in clinical psychiatry
and is intended for use by mental health professionals and for general clinical, educational and service use.
