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1. CONVERSION DISORDER
A. One or more symptoms or deficits affecting voluntary motor
or sensory function that suggest a neurological or other general
medical condition.
B. Psychological factors are judged to be associated with the
symptom or deficit because the initiation or exacerbation of the
symptom or deficit is preceded by conflicts or other stressors.
C. The symptom or deficit is not intentionally produced or
feigned (as in factitious disorder or malingering).
D. The symptoms or deficit cannot, after appropriate
investigation, be fully explained by a general medical
condition, or by the direct effects of a substance, or as a
culturally sanctioned behavior or experience.
E. The symptom or deficit causes clinically significant
distress or impairment in social, occupational, or other
important areas of functioning or warrants medical evaluation.
F. The symptom or deficit is not limited to pain or sexual
dysfunction, does not occur exclusively during the course of
somatization disorder, and is not better accounted for by
another mental disorder.
*Specify type of symptom or deficit:
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With motor symptom or deficit (eg, impaired coordination or
balance, paralysis, or localized weakness, difficulty swallowing
or "lump in throat," aphonia, and urinary retention).
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With sensory symptom or deficit (eg, loss of touch or pain
sensation, double vision, blindness, deafness, and
hallucinations).
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With seizures or convulsions: includes seizures
or convulsions with voluntary motor or sensory components.
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With
mixed presentation: if symptoms of more than one category are
evident.
2. SOMATIZATION DISORDER & UNDIFFERENTIATED SOMATIZATION
DISORDER
Somatization
Disorder:
A. A history of many physical complaints beginning before age
30 years that occur over a period of several years and result in
treatment being sought or significant impairment in social,
occupational, or other important areas of functioning.
B. Each of the following criteria must have been met, with
individual symptoms occurring at any time during the course of
the disturbance:
(1) four pain symptoms: a history of pain related to at least
four different sites or functions (eg, head, abdomen, back,
joints, extremities, chest, rectum, during menstruation, during
sexual intercourse, or during urination)
(2) two gastrointestinal symptoms: a history of at least two
gastrointestinal symptoms other than pain (eg, nausea, bloating,
vomiting, other than during pregnancy, diarrhea, or intolerance
of several different foods)
(3) one sexual symptom: a history of at least one sexual or
reproductive symptom other than pain (eg, sexual indifference,
erectile or ejaculatory dysfunction, irregular menses, excessive
menstrual bleeding, vomiting throughout pregnancy)
(4) one pseudoneurological symptom: a history of at least one
symptom or deficit suggesting a neurological condition not
limited to pain (conversion symptoms such as impaired
coordination or balance, paralysis or localized weakness,
difficulty swallowing or lump in throat, aphonia, urinary
retention, hallucinations, loss of touch or pain sensation,
double vision, blindness, deafness, seizures; dissociative
symptoms such as amnesia; or loss of consciousness other than
fainting)
C. Either (1) or (2):
(1) after appropriate investigation, each of the symptoms in
Criterion B cannot be fully explained by a known general medical
condition or the direct effects of a substance (eg, a drug of
abuse, a medication)
(2) when there is a related general medical condition, the
physical complaints or resulting social or occupational
impairment are in excess of what would be expected from the
history, physical examination, or laboratory findings
D. The symptoms are not intentionally produced or feigned (as
in factitious disorder or malingering).
Undifferentiated Somatization Disorder
A. One or more physical complaints (eg, fatigue, loss of
appetite, gastrointestinal complaints).
B. Either (1) or (2):
(1) after appropriate investigation, each of the symptoms in
Criterion B cannot be fully explained by a known general medical
condition or the direct effects of a substance (eg, a drug of
abuse, a medication)
(2) when there is a related general medical condition, the
physical complaints or resulting social or occupational
impairment are in excess of what would be expected from the
history, physical examination, or laboratory findings
C. The symptoms cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
D. The duration of the disturbance is at least 6 months.
E. The disturbance is not better accounted for by another
mental disorder (eg, another somatoform disorder, sexual
dysfunction, mood disorder, anxiety disorder, sleep disorder, or
psychotic disorder).
F. The symptom or deficit is not intentionally produced or
feigned (as in factitious disorder or malingering).
3. HYPOCHONDRIASIS
A. Preoccupation with fears of having, or the idea that one
has, a serious disease based on the person's misinterpretation
of bodily symptoms.
B. The preoccupation persists despite appropriate medical
evaluation and reassurance.
C. The belief in Criterion A is not of delusional intensity
(as in delusional disorder, somatic type) and is not restricted
to a circumscribed concern about appearance (as in body
dysmorphic disorder).
D. The symptoms cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
E. The duration of the disturbance is at least 6 months.
F. The preoccupation is not better accounted for by
generalized anxiety disorder, obsessive-compulsive disorder,
panic disorder, a major depressive episode, separation anxiety,
or another somatoform disorder.
*Specify if:
4. BODY DYSMORPHIC DISORDER
A. Preoccupation with an imagined defect in appearance. If a
slight physical anomaly is present, the person's concern is
markedly excessive.
B. The preoccupation causes clinically significant distress
or impairment in social, occupational, or other important areas
of functioning.
C. The preoccupation is not better accounted for by another
mental disorder (eg, dissatisfaction with body shape and size in
anorexia nervosa).
5. PAIN DISORDER
A. Pain in one or more anatomical sites is the predominant
focus of the clinical presentation and is of sufficient severity
to warrant clinical attention.
B. The pain causes clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
C. Psychological factors are judged to have an important role
in the onset, severity, exacerbation, or maintenance of the
pain.
D. The symptom or deficit is not intentionally produced or
feigned (as in factitious disorder or malingering).
E. The pain is not better accounted for by a mood, anxiety,
or psychotic disorder and does not meet criteria for dyspareunia.
*Specify if:
6. SOMATOFORM DISORDER NOT OTHERWISE SPECIFIED
The diagnostic category of somatoform disorder not otherwise
specified consists of a widely varied group of disorders that
mimic physical disease or have an uncertain psychological
relationship to physical disease. Included among these disorders
are:
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Pseudociesis
= False pregnancy
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Psychogenic urinary retention
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Mass psychogenic illness (so-called mass hysteria)
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