One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes... 2010 Fink & Schröder

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Andy, Apr 14, 2025.

  1. Andy

    Andy Retired committee member

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    Full title: One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders

    Abstract

    Background
    In order to clarify the classification of physical complaints not attributable to verifiable, conventionally defined diseases, a new diagnosis of bodily distress syndrome was introduced. The aim of this study was to test if patients diagnosed with one of six different functional somatic syndromes or a DSM-IV somatoform disorder characterized by physical symptoms were captured by the new diagnosis.

    Method
    A stratified sample of 978 consecutive patients from neurological (n=120) and medical (n=157) departments and from primary care (n=701) was examined applying post-hoc diagnoses based on the Schedules for Clinical Assessment in Neuropsychiatry diagnostic instrument. Diagnoses were assigned only to clinically relevant cases, i.e., patients with impairing illness.

    Results
    Bodily distress syndrome included all patients with fibromyalgia (n=58); chronic fatigue syndrome (n=54) and hyperventilation syndrome (n=49); 98% of those with irritable bowel syndrome (n=43); and at least 90% of patients with noncardiac chest pain (n=129), pain syndrome (n=130), or any somatoform disorder (n=178). The overall agreement of bodily distress syndrome with any of these diagnostic categories was 95% (95% CI 93.1–96.0; kappa 0.86, P<.0001). Symptom profiles of bodily distress syndrome organ subtypes were similar to those of the corresponding functional somatic syndromes with diagnostic agreement ranging from 90% to 95%.

    Conclusion
    Bodily distress syndrome seem to cover most of the relevant “somatoform” or “functional” syndromes presenting with physical symptoms, not explained by well-recognized medical illness, thereby offering a common ground for the understanding of functional somatic symptoms. This may help unifying research efforts across medical disciplines and facilitate delivery of evidence-based care.

    Paywall, although introduction and 'snippets' are available.
     
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  2. Utsikt

    Utsikt Senior Member (Voting Rights)

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  3. Utsikt

    Utsikt Senior Member (Voting Rights)

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  4. Trish

    Trish Moderator Staff Member

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    Is there anthing more daft than creating a 'diagnostic algorithm' that is designed to include people with a wide range of symptoms and diagnoses, and then 'discovering' that it indeed includes people with a wide range of symptoms and diagnoses. And then deciding on that artificial basis that they can all have the same 'evidence based care'.

    It's like a zoo keeper deciding it's too bothersome having different species with different characteristics and needs, so defining a 'diagnostic algorithm' of zoo animals called four-legs species which identifies animals according to whether they have 4 legs. Lo and behold you have created a new species that successfully includes tigers, pandas, toads, elephants and tortoises. You can now 'facilitate evidence based care' by putting them all in the same enclosure and feeding them all bamboo because what's good for a panda must be good for the rest of the four-legs species.
     
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  5. Yann04

    Yann04 Senior Member (Voting Rights)

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    that analogy hits hard because that is exactly how they see us. Burdens who need to be dealt with as fast as efficiently as possible, anything else would be wasting time on people undeserving of it.
     
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  6. rvallee

    rvallee Senior Member (Voting Rights)

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    Confirmed: circular definition is indeed, as designed, circular. More at 11.

    Who pays for this stuff? Oh, right, people who don't want to pay for sick people and would rather spend even more to produce worse outcomes for everyone.
     
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  7. Utsikt

    Utsikt Senior Member (Voting Rights)

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    In the case of Fink that is spot on.
    https://melivet.com/2021/04/22/me-the-insurance-industry-and-psychiatry/
     
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