Diagnostic Criteria for Psychosomatic Research - Revised version by Giovanni A. Fava and his research team

Abstract

Diagnostic Criteria for Psychosomatic Research (DCPR), developed by a team of Italian and American researchers at the end of the 20th century, was elaborated and then revised based on observations and studies conducted by clinicians. In this paper, we present their current version known as DCPR-R. This classification system departs from the functional/organic dichotomy of disorders. The new criteria allow for the assessment of the role of multiple emotional/behavioural dimensions and responses in the functioning of an affected person. The revised version has four diagnostic modules, i.e., stress, illness behaviour, psychological manifestation, and personality. The authors introduced an additional factor to describe life experiences that contribute to stress (allostatic overload). Illness behaviours include health anxiety, disease phobia, hypochondriasis, thanatophobia, illness denial, persistent somatisation, conversion, and anniversary reaction. Irritable mood, somatic symptoms secondary to a psychiatric disorder and demoralisation are psychological manifestations. Type A behaviour pattern and alexithymia are considered personality-related factors. The authors of DCPR-R proposed a certain number of criteria to be met in order to diagnose each of these syndromes. The system makes it possible to clearly determine the presence of a given syndrome, but it does not allow to assess its severity. Psychosomatic syndromes play an important role in the development and/or course of somatic diseases. Inclusion of these syndromes in clinical diagnosis has made it possible to expand the spectrum of information about patient's functioning, and, once they are diagnosed, offer appropriate psychological assistance, which will translate into an improvement in the quality of life.