Drs Gara and Escobar make an important point: The use of an extreme threshold for diagnosis of SD magnifies the unreliability of lifetime diagnosis. If one examines less extreme forms of somatization (such as the somatization syndrome described by Escobar et al1), a diagnosis based on lifetime recall is more reliable. We would caution, however, that any diagnosis based on lifetime recall of somatization symptoms rests on an unreliable foundation. Half of somatization symptoms reported at 1 diagnostic interview are not recalled 1 year later. Hence, we suggest that research and clinical attention might be better focused on a somatization syndrome defined by current symptoms.
Simon GE. The Stability of Somatization Syndromes Over Time—Reply. Arch Gen Psychiatry. 2001;58(1):94. doi: