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

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' ¹,²,³. 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 (van der Feltz-Cornelis et al., 2011; Hausteiner-Wiehle et al., 2013).

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 (Hausteiner-Wiehle et al., 2013). These symptoms must be persistent, typically for at least six months, and cause significant distress or functional impairment (Hausteiner-Wiehle et al., 2013). The diagnostic approach for these conditions often involves a multidisciplinary perspective (van der Feltz-Cornelis et al., 2011).