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Kroenke and associates¹ provided an important alternative to the diagnosis of undifferentiated somatoform disorder. They examined the validity of the criteria for multisomatoform disorder, defined as 3 or more medically unexplained, currently bothersome, physical symptoms associated with a long (2 years) history of somatization. A multisomatoform disorder was diagnosed in 8.2% of 1000 primary care patients. We doubt, however, that this may entail a solution to the considerable limitations of the DSM-IV criteria for somatoform disorders in medical practice. The criteria are in fact cumbersome, difficult to use, either too restrictive (eg, somatization disorder) or too vague, and fail to identify many forms of somatization worthy of clinical attention.^2-3 Further, the classification "reflects mind-body dualism and perpetuates the questionable dichotomy of organic vs psychogenic disorders and symptoms."²

An alternative diagnostic and conceptual framework has been proposed by an international group of psychosomatic investigators.⁴ A set of 12 diagnostic criteria . . . [Full Text of this Article]

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