[DSM-5: from 'somatoform disorders' to 'somatic symptom and related disorders'].

BACKGROUND: The DSM-IV somatoform disorder category was controversial and has undergone major changes in DSM-5.

AIM: To provide a critical description of DSM-5 somatic symptoms and related disorders (SSD).

METHOD: To review the new classification system for somatic symptom and related disorders (SSD) as set out in DSM-5 RESULTS: Whereas the symptoms of somatoform disorder were always considered to be medically unexplained, in DSM-5 the symptoms of somatic symptom disorder can now sometimes be explained by a medical condition. The criterion is that the individual has a maladaptive reaction to a somatic symptom. In DSM-5 the terms somatisation disorder, pain disorder and undifferentiated somatoform disorder have been discarded, whereas factitious disorder as well as psychological factors affecting other medical conditions have been added to somatic symptom disorder and other disorders. Conversion disorder remains as it was in DSM-IV. Hypochondriasis has been renamed 'illness anxiety disorder'.

CONCLUSION: The new description of somatic symptom disorder in DSM-5 represents a big step forwards, because the decision has been made to use, for classification, a positive criterion, namely maladaptive reaction to a somatic symptom, instead of the earlier negative criterion, namely that the symptoms should be medically unexplained. Before attaching the ssd label to an illness, the clinician will have to weigh up the clinical consequences of this psychiatric diagnosis.