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Bodily Distress Disorder ICD-11 — MRCPsych Paper B MCQ

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HardLiaison PsychiatryBodily Distress Disorder ICD-11MRCPsych Paper B

A 42-year-old woman reports 18 months of pain, fatigue and gastrointestinal symptoms. Some symptoms occur alongside stable inflammatory bowel disease, but she remains excessively preoccupied with their seriousness despite appropriate assessment and reassurance. She repeatedly seeks healthcare consultations and her functioning is substantially impaired. There is no intentional production of symptoms or identifiable external incentive, and the presentation is not confined to loss of neurological function. Which ICD-11 diagnostic category represents the principal replacement for most ICD-10 somatoform disorders in this presentation?

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Correct answer: E — Bodily distress disorder

The answer is **B, bodily distress disorder**. ICD-11 replaced most ICD-10 somatoform disorders with this single category, graded by severity. Diagnosis rests on persistent distressing bodily symptoms together with excessive symptom-focused attention or preoccupation and associated impairment—not simply on symptoms being medically unexplained. The symptoms are genuine and bodily distress disorder can coexist with physical disease, as in this patient with inflammatory bowel disease. Dissociative neurological symptom disorder applies to functional disturbances of neurological function rather than this multisystem presentation. Factitious disorder requires intentional falsification or induction of symptoms in the absence of an obvious external reward. Malingering involves intentional symptom production for external gain and is not a mental disorder. The ICD-10 somatoform categories were not retained unchanged.

Reference: Keeley J et al. Case-controlled field study of the ICD-11 clinical descriptions and diagnostic requirements for Bodily Distress Disorders. Journal of Affective Disorders. 2023;333:271–277. https://pubmed.ncbi.nlm.nih.gov/37100177/