Lumpers versus splitters

Abstract

Various names have been given to medically unexplained symptoms: somatization, functional somatic symptoms or syndromes, and somatoform disorders. Different conceptualizations of disorders of somatization have been proposed: somatization disorder (DSM-IV) and a number of subsyndromal variations, such as somatic symptom index, multisomatoform disorder, and polysymptomatic somatoform disorder1. These symptoms pose a major challenge to medicine and are subject to much debate. Medically unexplained symptoms are common, persistent, and are accompanied with distress, disability, and substantial utilization of healthcare resources.