What criteria should I use to diagnose somatisation disorder in a patient with medically unexplained symptoms?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

The provided UK guidelines, such as those for rehabilitation after critical illness, depression in adults, or myalgic encephalomyelitis/chronic fatigue syndrome, do not specify direct diagnostic criteria for 'somatisation disorder' ,,. However, recent international guidelines and literature address the diagnosis of 'somatoform disorders' and 'medically unexplained physical symptoms' (MUPS), which encompass the concepts previously associated with somatisation disorder .

When a patient presents with medically unexplained symptoms, the focus in newer guidelines for functional and somatoform disorders shifts from a specific number of symptoms to the presence of distressing physical symptoms accompanied by significant thoughts, feelings, or behaviours related to these symptoms . These symptoms must be persistent, typically for at least six months, and cause significant distress or functional impairment . The diagnostic approach for these conditions often involves a multidisciplinary perspective .

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