Highlights of Changes From DSM-IV to DSM-5 813
ously diagnosed with somatization disorder wi ll usually have sympto ms that meet DSM-5
criteria for somatic symptom disorder,  but only if they have th e maladaptive thoughts, feel-
ings, and behaviors that define the disorder, in addition to their somatic symptoms. Because
the distinction between somati zation disorder and undifferen tiated somatoform disorder
was arbitrary, they are merged in DSM-5 un der somatic symptom diso rder. Individuals pre-
viously diagnosed with hypochondriasis who have high health anxiety but no somatic symp-
toms would receive a DSM-5 diagnosis of illness anxiety disorder (unless their health
anxiety was better explained by  a primary anxiety disorder, su ch as generalized anxiety dis-
order). Some individuals with chronic pain w ould be appropriately di agnosed as having so-
matic symptom disorder, with predominant pain . For others, psychological factors affecting
other medical conditions or an adjustment disorder would be more appropriate.
Psychological factors affect ing other medical conditions  is a new mental disorder in
DSM-5, having formerly been listed in the DSM-IV chapter “Other Conditions That May
Be a Focus of Clinical At tention.” This disorder and factitious disorder  are placed among
the somatic symptom and related disorders because somatic symptoms are predominant
in both disorders, and both are most often en countered in medical settings. The variants of
psychological factors affecting other medical conditions are removed in favor of the stem
diagnosis. Criteria for conversion disorder (functional neurological symptom disorder)
have been modified to emphasize the essent ial importance of the neurological examina-
tion, and in recognition that relevant psychological factors may not be demonstrable at the
time of diagnosis. Other spec ified somatic symptom disorder , other specified illness anx-