- Last Updated: 23 January 2016 23 January 2016
The introductory explanation text of CSSD in the Draft unfortunately lacks the requisite scientific rigor and specificity for medical and psychiatric differential diagnosis.
The CSSD diagnostic criteria in many instances would reasonably diagnose a percentage of patients: such patients would be abnormally concerned/preoccupied with actual medical symptoms, over-interpretation of bodily sensations, or the somatic projection of ideational content—to the point where such processes become pathological. The example of the true hypochondriac or the patient who easily somatizes feelings would validate a portion of the CSSD definition.
However, at the same time, the CSSD criteria is so broad that it draws no clear boundary between the patient responding within normal expectations to an actual medical condition, and patients who are pathologically misapprehending or excessively concerned. By unscientifically conflating two major groups of patients, the draft criteria must result in a substantial number of cases in which reasonable and appropriate patient responses to actual physical illness are falsely psychologized. Such a lack of diagnostic clarity creates an amorphous and contradictory criteria for misdiagnosis—with severe consequences for patient suffering and possible medical malpractice.