Somatoform disorders in childhood and adolescence: Prospects for the DSM-V

The validity, reliability and clinical utility of the current DSM-IV-TR criteria for somatoform disorders are highly debated. The DSM-V workgroup therefore recommends restructuring and renaming the category into Somatic Symptom Disorders. In this article the suitability of the current DSM-IV-TR criteria of somatoform disorders and the suitability of the criteria of the Complex Somatic Symptom Disorder for the classification of children and adolescents are analyzed. Especially the somatization disorder is inappropriate for children and adolescents. General limitations of the DSM approach to classifying child and adolescent psychopathology are delineated. Studies show that the mental and physical well being of parents have a strong impact on the development and maintenance of somatoform disorders in children/adolescents as well as the children's/adolescents' health care utilization. Therefore, these disorders cannot be discussed in children without considering the parents. The latest draft of the Complex Somatic Symptom Disorder considers this special situation of children/adolescents; the diagnosis can also be given when parents exhibit excessive thoughts, feelings and behaviors related to the child's somatic symptoms.