ICD-11 Criteria for Bodily Distress Disorder (6C20)

Bodily distress disorder is characterised by the presence of bodily symptoms that are distressing to the individual and excessive attention directed toward the symptoms, which may be manifest by repeated contact with health care providers. If another health condition is causing or contributing to the symptoms, the degree of attention is clearly excessive in relation to its nature and progression. Excessive attention is not alleviated by appropriate clinical examination and investigations and appropriate reassurance. Bodily symptoms are persistent, being present on most days for at least several months. Typically, bodily distress disorder involves multiple bodily symptoms that may vary over time. Occasionally there is a single symptom—usually pain or fatigue—that is associated with the other features of the disorder. The symptoms and associated distress and preoccupation have at least some impact on the individual’s functioning (e.g. strain in relationships, less effective academic or occupational functioning, abandonment of specific leisure activities).

Exclusions:

Tourette syndrome (8A05.00)
Hair pulling disorder (6B25.0)
Dissociative disorders (BlockL1‑6B6)
hair-plucking (6B25.0)
Hypochondriasis (6B23)
Body dysmorphic disorder (6B21)
Excoriation disorder (6B25.1)
Gender incongruence (BlockL1‑HA6)
Sexual dysfunctions (BlockL1‑HA0)
Tic disorders (8A05)
Sexual pain-penetration disorder (HA20)
Postviral fatigue syndrome (8E49)
Chronic fatigue syndrome (8E49)
Myalgic encephalomyelitis (8E49)

6C20.0 Mild bodily distress disorder

All definitional requirements of bodily distress disorder are present. There is excessive attention to distressing symptoms and their consequences, which may result in frequent medical visits, but the person is not preoccupied with the symptoms (e.g., the individual spends less than an hour per day focusing on them). Although the individual expresses distress about the symptoms and they may have some impact on his or her life (e.g., strain in relationships, less effective academic or occupational functioning, abandonment of specific leisure activities), there is no substantial impairment in the person’s personal, family, social, educational, occupational, or other important areas of functioning.

6C20.1 Moderate bodily distress disorder

All definitional requirements of bodily distress disorder are present. There is persistent preoccupation with the distressing symptoms and their consequences (e.g., the individual spends more than an hour a day thinking about them), typically associated with frequent medical visits. The person devotes much of his or her energy to focusing on the symptoms and their consequences. The symptoms and associated distress and preoccupation cause moderate impairment in personal, family, social, educational, occupational, or other important areas of functioning (e.g., relationship conflict, performance problems at work, abandonment of a range of social and leisure activities).

6C20.2 Severe bodily distress disorder

All definitional requirements of Bodily distress disorder are present. There is pervasive and persistent preoccupation with the symptoms and their consequences to the extent that these may become the focal point of the person’s life, typically resulting in extensive interactions with the health care system. The symptoms and associated distress and preoccupation cause serious impairment in personal, family, social, educational, occupational, or other important areas of functioning (e.g., unable to work, alienation of friends and family, abandonment of nearly all social and leisure activities). The person’s interests may become so narrow so as to focus almost exclusively on his or her bodily symptoms and their negative consequences.

6C20.Z Bodily distress disorder, unspecified

REFERENCE:

International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.

https://creativecommons.org/licenses/by-nc-nd/3.0/igo/

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