322 Somatic Symptom and Related Disorders
Psychological Factors Affecting
 Other Medical Conditions
Diagnostic Criteria 316 (F54)
A. A medical symptom or condition (other than a mental disorder) is present. 
B. Psychological or behavioral factors adversely affect the medical condition in one of the
following ways: 
1. The factors have influenced the course of the medical condition as shown by a
close temporal association between the psychological factors and the development
or exacerbation of, or delayed recovery from, the medical condition.
2. The factors interfere with the treatment of the medical condition (e.g., poor adher-
ence).
3. The factors constitute additional well-established health risks for the individual.
4. The factors influence the underlying pathophysiology, precipitating or exacerbating
symptoms or necessitating medical attention.
C. The psychological and behavioral factors in Criterion B are not better explained by an-
other mental disorder (e.g., panic disorder , major depressive disorder, posttraumatic
stress disorder).
Specify current severity:
Mild:  Increases medical risk (e.g., inconsistent adherence with antihypertension treat-
ment). 
Moderate: Aggravates underlying medical condition (e.g., anxiety aggravating
asthma).
Severe:  Results in medical hospitalization or emergency room visit.
Extreme: Results in severe, life-threatening risk (e.g., ignoring heart attack symp-
toms).
Diagnostic Features
The essential feature of  psychological factors affecting other medical conditions is the
presence of one or more clinically significant  psychological or behavi oral factors that ad-
versely affect a medical condition by increasi ng the risk for suffering, death, or disability
(Criterion B). These factors can adversely affe ct the medical condition by influencing its