Bodily sensations in diagnostics of psychiatry, neurology and psychosomatics
In practice it is sometimes more difficult to make a satisfactory classification using the ICD-10 than using the previous 9th version (ICD-9). A survey of the DGPPN on the ICD-10 in autumn 2008 – in preparation for the planned ICD-11 – was a welcome opportunity for some members of the Working Group for Psychosomatics and Neurology (AGPN) to reflect systematically and name the flaws in the currently valid International Classification of Mental and Behavioural Disorders. In this process a guiding principle emerged, which allows to identify and bundle the points in need of amendment especially clearly: the diagnostic significance of the subjective bodily symptoms, the »body’s complaints« (»Körperklagen«, 10). The authors find the complex of symptoms in bodily sensations suitable for revaluing clinical phenomena underrepresented in the ICD-10, adding them to the classifications and also, in some cases, more clearly differentiating the existing categories and re-ordering them. Since negative bodily sensations, as subjective phenomena, can only be observed by listening to the patients‘ descriptions, systematic attention to the sensations means a distinct re-evaluation of the doctor’s receptive attitude as the basis for a reliable diagnosis. Psychodynamics is essential in this context. The following account adheres to the »general questions« 8 to 11 in the DGPPN survey.
sieh auch Mechthilde Kütemeyer