Former hypochondriasis now classified as two separate disorders

In the updated version of the DSM-5, hypochondriasis and several conditions with related symptoms have been replaced by somatic symptom disorder and illness anxiety disorder, according to a Mayo Clinical Update.

To meet the criteria for somatic symptom disorder, patients must exhibit behaviors of preoccupation or fear over one or more chronic somatic symptoms, to the point they cause significant distress and dysfunction. Patients may also make frequent trips to healthcare services, rarely feel content with their diagnosis, and feel their care was not sufficient.

Patients with illness anxiety disorder have heightened bodily sensations, specifically when faced with the possibility of an undiagnosed illness. These patients also exhibit a devotion of time and energy to their health concerns.

Many health professionals are skeptical about this new recategorization, arguing the definitions are too broad and could lead to overdiagnosis.

But Jeffrey Staab, MD, a professor of psychiatry at Rochester, Minn.-based Mayo Clinic, participated in the somatic symptom disorder trials and advocates for the reclassification.

"People who have reasonable health concerns will not get the diagnosis," Dr. Staab told Mayo Clinical Update. "By eliminating the concept of medically unexplained symptoms, the DSM-5 criteria prevent the easy assumption of a psychiatric diagnosis in patients who present with medical symptoms of unclear etiology."

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