The Diagnosis of Persistent Somatoform Pain Disorder

According to the clinical diagnostic guidelines ICD-10 should be criticized in several ways:

1. Ignoring the organic substrate does not reflect the reality of the pain, even if they are primarily psychological or psychosocial reasons. With this diagnosis, the body-soul dualism Cartesian reflect that there is "real", that pain-related physical and imaginary, that is mentally induced pain. After the biopsychosocial model of disease different definitions would be more appropriate. The term "pain disorder" without "somatoform" when he was elected in the DSM-IV, not the fact that the "psychogenic" pain caused by organic substrates (may) have, although this is due to the current state of the science is often still not sufficiently known. The concept of persistent somatoform pain disorder according to the clinical diagnostic guidelines for ICD-10 exposed to the risk that should initially umdiagnostiziert as "somatoform" pain disorder is defined through the advancement of medical science, more and more, because of the organic substrate is detected, although at the same symptoms of mental and psychosocial factors involved as before.
2. Realization of psycho-physiological mechanisms, such as is the case with painful muscle tension (tension headaches), will lead to a different diagnosis of F45.4, which is the main code of non-psychiatric field, although psychosocial stressors known as triggers. This criticism is not mitigated by the fact that the ICD-10 pain described also not pure organic referred to as "somatoform".
3. In ICD-10, which is quite important differences between acute and chronic somatoform pain disappear. The suffix "persistent" ignores the difference between acute and chronic pain, such as that carried out in the DSM-IV. With the requirement for persistent pain pain disorders in ICD-10 is ignored so that last less than six months. In pain lasting psychological and social factors that are shorter also play an important role.

ICD-10 diagnosis of "persistent somatoform pain disorder" diagnosis is based on the same problematic "somatoform pain disorder" of the previous American Psychiatric diagnostic scheme DSM-III-R. This diagnosis is not suitable for many patients with chronic pain and does not apply to patients with acute pain, where both psychological and social factors in pain trigger or amplify.

DSM-III-R call for continued work with the pain for at least six months, while DSM-IV considers the pain itself as the main criteria for diagnosis. It was at that time not yet distinguish between acute and chronic pain.