achieved by assessing the somatic complaints alone.
The principles behind the changes in the somatic symptom and related diagnoses from
DSM-IV are crucial in understanding th e DSM-5 diagnoses. The DSM-IV term somatoform
disorders  was confusing and is replaced by somatic symptom and related disorders . In DSM-IV
there was a great deal of over lap across the somatoform disorders and a lack of clarity
about the boundaries of diag noses. Although individuals wi th these disorders primarily
present in medical rather than mental health  settings, nonpsychiatric physicians found the
DSM-IV somatoform diagnoses difficult to understand and use. The current DSM-5 clas-
sification recognizes this overlap by reducing the total number of disorders as well as their
subcategories.
The previous criteria overemphasized the cent rality of medically unexplained symptoms.
Such symptoms are present to various degrees, particularly in conver sion disorder, but so-
matic symptom disorders can also accompany diagnosed medical disorders. The reli-
ability of determining that a somatic sympto m is medically unexplai ned is limited, and
grounding a diagnosis on the absence of an  explanation is problematic and reinforces
mind-body dualism. It is not appropriate to give  an individual a mental disorder diagnosis
solely because a medical cause cannot be demo nstrated. Furthermore, the presence of a
medical diagnosis does not exclude the possibility of a comorbid ment al disorder, includ-
ing a somatic symptom and related disorder. Perhaps because of the predominant focus
on lack of medical explanation, individuals re garded these diagnoses as pejorative and de-
meaning, implying that their physical symp toms were not “real.” The new classification
defines the major diagnosis, somatic symptom d isorder, on the basis of positive symptoms