Drs Fava and Porcelli draw attention to important issues in the classification of somatoform disorders. Although the DCPR are an ambitious effort to operationalize distinct syndromes, the authors admit that validation is necessary.1 Moreover, what they propose may in fact be too much for clinical use. Passionate about the study of particular disorders, psychiatric researchers have at times created an abundance of diagnostic categories with detailed criteria. Busy clinicians, on the other hand, tend to be lumpers rather than splitters. The DCPR comprise 12 different categories, some of which are controversial (eg, alexithymia2), potentially overrefined (eg, disease phobia as a separate diagnosis from hypochondriasis), or are single symptoms so prevalent in general medical patients that subthreshold rather than pathological diagnostic status may be warranted (eg, health anxiety, irritability, illness denial).
Kroenke K. Multisomatoform Disorder. Arch Gen Psychiatry. 1998;55(8):756–757. doi: