XXXX and recent diagnostic controversies.

@entity1 @entity2270 @entity2531 @entity158
Classification is not a trivial matter. In Burmese Days, George Orwell writes, "It is devilish to suffer from a @entity158 that is all but nameless. Blessed are they who are stricken only with classifiable diseases! Blessed are the poor, the sick, the crossed in love, for at least other @entity1 know what is the matter with them and will listen to their belly-achings with sympathy." @entity1 who have @entity2531 are particularly susceptible to this Orwellian lamentation. They are afflicted by symptoms that defy simple explanations. As detailed in this article, there is a spectrum of medical and psychiatric factors that can cause or contribute to somatic symptom burden. Research is continuing to reveal the central mechanisms that may provide a common pathway for physical and psychologic symptoms. The dualism that places some somatic symptom disorders on @entity2270 and others on @entity2270 III gradually may fade in the coming decades as what the unifying causes are among common symptoms and the multicausal nature of many symptoms are discovered. Meanwhile, the classification systems should continue to operate on pragmatic principles where mechanistic explanations are lacking. This will allow grouping @entity1 into categories that inform research, scientific and @entity1 communication, prognostication, and clinical management. Coupling a heuristic classification system with evidence-based measures for assessing severity and monitoring treatment outcomes are important steps in the optimal care of symptomatic @entity1 .
