Disorders of Bodily Distress and Bodily Experience

This chapter covers the ICD-11 classification of disorders of bodily distress and bodily experience and how this classification changed from the preceding ICD-10 somatoform disorders. It deals with the classification of chronic pain in combination with distress, and given that the DSM-5 diagnostic criteria for SSRD include conversion disorder, that is, in the ICD-11 chapter on dissociative disorders, dissociative neurological symptom disorder will be covered here and in the chapter on dissociative disorders. This chapter discusses the change toward distress related to bodily symptoms as the main criterion for classification as bodily distress disorder, independent of the question if they occurred in the context of medically unexplained symptoms or a known medical condition. The meaning of this shift for research and clinical diagnosis and management is discussed. As a response to the current opiate crisis in distressed chronic pain patients, research of an alternative to the WHO pain ladder is discussed that shifts the focus toward the use of adjuvant pain medication and away from opiates.