Abstract:
BACKGROUND:Functional somatic symptoms and disorders are common and complex phenomena involving both bodily and brain processes. They pose major challenges across medical specialties. These disorders are common and have significant impacts on patients' quality of life and healthcare costs. MAIN BODY:We outline five problems pointing to the need for a new classification: (1) developments in understanding aetiological mechanisms; (2) the current division of disorders according to the treating specialist; (3) failure of current classifications to cover the variety of disorders and their severity (for example, patients with symptoms from multiple organs systems); (4) the need to find acceptable categories and labels for patients that promote therapeutic partnership; and (5) the need to develop clinical services and research for people with severe disorders. We propose 'functional somatic disorders' (FSD) as an umbrella term for various conditions characterised by persistent and troublesome physical symptoms. FSDs are diagnosed clinically, on the basis of characteristic symptom patterns. As with all diagnoses, a diagnosis of FSD should be made after considering other possible somatic and mental differential diagnoses. We propose that FSD should occupy a neutral space within disease classifications, favouring neither somatic disease aetiology, nor mental disorder. FSD should be subclassified as (a) multisystem, (b) single system, or (c) single symptom. While additional specifiers may be added to take account of psychological features or co-occurring diseases, neither of these is sufficient or necessary to make the diagnosis. We recommend that FSD criteria are written so as to harmonise with existing syndrome diagnoses. Where currently defined syndromes fall within the FSD spectrum - and also within organ system-specific chapters of a classification - they should be afforded dual parentage (for example, irritable bowel syndrome can belong to both gastrointestinal disorders and FSD). CONCLUSION:We propose a new classification, 'functional somatic disorder', which is neither purely somatic nor purely mental, but occupies a neutral space between these two historical poles. This classification reflects both emerging aetiological evidence of the complex interactions between brain and body and the need to resolve the historical split between somatic and mental disorders.
journal_name
BMC Medjournal_title
BMC medicineauthors
Burton C,Fink P,Henningsen P,Löwe B,Rief W,EURONET-SOMA Group.doi
10.1186/s12916-020-1505-4subject
Has Abstractpub_date
2020-03-03 00:00:00pages
34issue
1issn
1741-7015pii
10.1186/s12916-020-1505-4journal_volume
18pub_type
杂志文章相关文献
BMC Medicine文献大全abstract:BACKGROUND:Insulin-like growth factor-1 (IGF-I) signalling is important for cancer initiation and progression. Given the emerging evidence for the role of the stroma in these processes, we aimed to characterize the effects of IGF-I on cancer cells and stromal cells separately. METHODS:We used an ex vivo culture model ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-8-1
更新日期:2010-01-05 00:00:00
abstract::Proteinuria is a defining criterion for the diagnosis of pre-eclampsia. The amount of protein lost per day has been thought by some to predict both maternal and fetal outcome. The systematic review of 16 primary papers including over 6700 patients by Thangaratinam and colleagues published this month in BMC Medicine su...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/1741-7015-7-11
更新日期:2009-03-24 00:00:00
abstract::Alzheimer's disease is a devastating neurological disorder that affects more than 37 million people worldwide. The economic burden of Alzheimer's disease is massive; in the United States alone, the estimated direct and indirect annual cost of patient care is at least $100 billion. Current FDA-approved drugs for Alzhei...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/1741-7015-7-7
更新日期:2009-02-19 00:00:00
abstract:BACKGROUND:Obesity is common in young women, increasing insulin resistance (IR) and worsening pregnancy complications, including gestational diabetes (GDM). Women with polycystic ovary syndrome (PCOS) are commonly obese, which aggravates the severity of PCOS clinical expression. Relationships between these common insul...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0957-7
更新日期:2017-11-06 00:00:00
abstract:BACKGROUND:Israeli citizens have been exposed to intense and ongoing terrorism since September 2000. We previously studied the mental health impact of terrorism on the Israeli population (Bleich et al., 2002), however the long-term impact of ongoing terrorism has not yet been examined. The present study evaluated the p...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-4-21
更新日期:2006-08-27 00:00:00
abstract:BACKGROUND:Alcohol consumption is a leading contributor to death and disability worldwide, but previous research has not examined the effects of different patterns of alcohol consumption. The study objective was to understand the relationship between different alcohol consumption patterns and adverse health outcomes ri...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01878-2
更新日期:2021-01-12 00:00:00
abstract:BACKGROUND:Guidelines recommend that clinicians should make brief opportunistic behavioural interventions to patients who are obese to increase the uptake of effective weight loss programmes. The objective was to assess the effect of this policy on socioeconomic equity. METHODS:One thousand eight hundred eighty-two co...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-019-1284-y
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Cognitive impairment is very common in late-life depression, principally affecting executive skills and information processing speed. The aim of the study was to examine the effect of antidepressant treatment on cognitive performances over a 10-year period. METHODS:The community-based cohort included 7381 p...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0847-z
更新日期:2017-04-19 00:00:00
abstract:BACKGROUND:Alcoholic beverages are widely consumed. Depression, the most prevalent mental disorder worldwide, has been related to alcohol intake. We aimed to prospectively assess the association between alcohol intake and incident depression using repeated measurements of alcohol intake. METHODS:We followed-up 5,505 h...
journal_title:BMC medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1741-7015-11-192
更新日期:2013-08-30 00:00:00
abstract:BACKGROUND:To reduce inequalities between individuals with and without mental health problems, a better understanding is required of triggers and success of quit attempts among the third of smokers with mental health problems. The aim was to assess whether there are differences by mental health status in (i) triggers f...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01617-7
更新日期:2020-06-25 00:00:00
abstract:BACKGROUND:The Diagnostic and Statistical Manual fifth edition (DSM-5) provides new criteria for delirium diagnosis. We examined delirium diagnosis using these new criteria compared with the Diagnostic and Statistical Manual fourth edition (DSM-IV) in a large dataset of patients assessed for delirium and related presen...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-014-0164-8
更新日期:2014-09-30 00:00:00
abstract:BACKGROUND:Stunting affects more than 161 million children worldwide and can compromise cognitive development beginning early in childhood. There is a paucity of research using neuroimaging tools in conjunction with sensitive behavioral assays in low-income settings, which has hindered researchers' ability to explain h...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-019-1431-5
更新日期:2019-11-25 00:00:00
abstract:BACKGROUND:Tobacco smoking is a leading cause of cardiovascular disease (CVD) morbidity and mortality. Evidence on the relation of smoking to different subtypes of CVD, across fatal and non-fatal outcomes, is limited. METHODS:A prospective study of 188,167 CVD- and cancer-free individuals aged ≥ 45 years from the Aust...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-019-1351-4
更新日期:2019-07-03 00:00:00
abstract:BACKGROUND:Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-015-0314-7
更新日期:2015-05-06 00:00:00
abstract:BACKGROUND:Monogenic diabetes (MgD) accounts for 1-2% of all diabetes cases. In adults, MgD is difficult to distinguish from common diabetes causes. We assessed the diagnosis rate and genetic spectrum of MgD using next-generation sequencing in patients with late adolescence/adult-onset diabetes referred for a clinical ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-019-1363-0
更新日期:2019-07-11 00:00:00
abstract:BACKGROUND:The UK Clinical Aptitude Test (UKCAT) has been shown to have a modest but statistically significant ability to predict aspects of academic performance throughout medical school. Previously, this ability has been shown to be incremental to conventional measures of educational performance for the first year of...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-016-0682-7
更新日期:2016-09-26 00:00:00
abstract:BACKGROUND:Over the last 100 years, several persistent misconceptions or 'false beliefs' have built up around allergen immunotherapy and its use in allergic rhinitis. This is perhaps because enthusiastic physicians administered complex allergen extracts to a diverse population of patients suffering from heterogeneous a...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/1741-7015-11-255
更新日期:2013-12-05 00:00:00
abstract::A series of primarily laboratory-based studies found attention bias modification in socially anxious participants to lead to reduced anxiety. It is argued that the failure to replicate the positive results of attention bias modification in the study of Carlbring et al. may be due to reasons other than the application ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-63
更新日期:2012-06-25 00:00:00
abstract:BACKGROUND:Resistance and tolerance to Plasmodium falciparum can determine the progression of malaria disease. However, quantitative evidence of tolerance is still limited. We investigated variations in the adverse impact of P. falciparum infections among African pregnant women under different intensities of malaria tr...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0893-6
更新日期:2017-07-17 00:00:00
abstract:BACKGROUND:Inflammatory cytokines play a crucial role in coronary artery disease (CAD). We investigated the association between 48 coding and three non-coding single nucleotide polymorphisms (SNPs) from 35 inflammatory genes and the development of CAD, using a large discordant sibship collection (2699 individuals in 89...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-8-5
更新日期:2010-01-13 00:00:00
abstract:BACKGROUND:Thymic size in early infancy predicts subsequent survival in low-income settings. The human thymus develops from early gestation, is most active in early life and is highly sensitive to malnutrition. Our objective was to test whether thymic size in infancy could be increased by maternal and/or infant nutriti...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-019-1264-2
更新日期:2019-02-18 00:00:00
abstract:BACKGROUND:The use of early morning sputum samples (EMS) to diagnose tuberculosis (TB) can result in treatment delay given the need for the patient to return to the clinic with the EMS, increasing the chance of patients being lost during their diagnostic workup. However, there is little evidence to support the superior...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0947-9
更新日期:2017-10-27 00:00:00
abstract::Intra-tumour heterogeneity is a common molecular phenomenon in metastatic clear cell renal carcinoma (mRCC), representing the genetic complexity of a tumour with multiple metastatic sites. The present commentary discusses the observed phenomena of phenotypic intra-tumour heterogeneity in mRCC patients treated with the...
journal_title:BMC medicine
pub_type: 社论
doi:10.1186/s12916-016-0754-8
更新日期:2016-12-07 00:00:00
abstract:BACKGROUND:Cognitive impairment is common in patients with cerebral small vessel disease, but is not well detected using common cognitive screening tests which have been primarily devised for cortical dementias. We developed the Brief Memory and Executive Test (BMET); a rapid screening measure sensitive to the impaired...
journal_title:BMC medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1186/s12916-015-0290-y
更新日期:2015-03-11 00:00:00
abstract:BACKGROUND:The spread of infectious diseases crucially depends on the pattern of contacts between individuals. Knowledge of these patterns is thus essential to inform models and computational efforts. However, there are few empirical studies available that provide estimates of the number and duration of contacts betwee...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-9-87
更新日期:2011-07-19 00:00:00
abstract:BACKGROUND:The treatment of patients with haematological malignancies by means of haematopoietic stem cell transplantation (HSCT) is often accompanied by life threatening infections. With emerging antimicrobial resistance there is an increased need for new agents, with a beneficial safety profile. Therefore we evaluate...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/1741-7015-7-44
更新日期:2009-09-08 00:00:00
abstract::Although strong evidence exists that the benefits of vaccination by far outweigh potential adverse events, controversy still exists. This has led opponents of vaccination to question its safety, efficacy and necessity. In an interview with Professor Elizabeth Miller, we discuss the continuum of beliefs held by vaccine...
journal_title:BMC medicine
pub_type: 面试
doi:10.1186/s12916-015-0508-z
更新日期:2015-10-16 00:00:00
abstract:BACKGROUND:Breast cancer patients who have not previously attended mammography screening may be more likely to discontinue adjuvant hormone therapy and therefore have a worse disease prognosis. METHODS:We conducted a population-based cohort study using data from Stockholm Mammography Screening Program, Stockholm-Gotla...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-019-1252-6
更新日期:2019-01-31 00:00:00
abstract:BACKGROUND:Severe iodine insufficiency in pregnancy has significant consequences, but there is inadequate evidence to indicate what constitutes mild or moderate insufficiency, in terms of observed detrimental effects on pregnancy or birth outcomes. A limited number of studies have examined iodine status and birth outco...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01602-0
更新日期:2020-06-11 00:00:00
abstract:BACKGROUND:Populations exposed to humanitarian emergencies are particularly vulnerable to mental health problems, including new onset, relapse and deterioration of psychotic disorders. Inadequate care for this group may lead to human rights abuses and even premature death. The WHO Mental Health Gap Action Programme Int...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0960-z
更新日期:2017-12-11 00:00:00