- F45
- Anxiety Disorders
Somatoform Disorders (F45)
DSM-5-TR: Somatic Symptom and Related Disorders
ICD-10-AM and DSM-5-TR may classify conditions differently. Refer to APA and WHO for complete diagnostic criteria.
Key Facts
- ICD-10 RangeF40-F48
- Subcodes7 subcodes
- Australian PrevalenceCommonly encountered in Australian general practice. Medically unexplained symptoms account for up to 30% of GP consultations.
- Global PrevalencePrevalence varies widely by definition; somatic symptom disorders affect approximately 5-7% of the general population.
- Duration RequirementSomatisation disorder (F45.0): at least two years of multiple, varying physical symptoms. Hypochondriasis (F45.2): persistent preoccupation lasting at least 6 months.
Overview
Somatoform disorders involve repeated presentation of physical symptoms together with persistent requests for medical investigations, despite repeated negative findings and reassurance that the symptoms have no physical basis. The symptoms are not intentionally produced and the person experiences genuine distress.
Diagnostic Criteria (ICD-10)
Core Features
- Multiple, recurrent, and frequently changing physical symptoms
- Persistent requests for medical investigation despite negative findings
- Refusal to accept medical reassurance that symptoms have no physical basis
- Symptoms not intentionally produced or feigned
- Significant functional impairment or distress
Duration Somatisation disorder (F45.0): at least two years of multiple, varying physical symptoms. Hypochondriasis (F45.2): persistent preoccupation lasting at least 6 months.
Exclusion Criteria
- Intentional production of symptoms (use factitious disorder or malingering)
- Symptoms fully explained by a medical condition
- Dissociative (conversion) disorders (use F44)
ICD-10-AM Subcodes
| Code | Name | Description |
|---|---|---|
| F45.0 | Somatisation disorder | Multiple, recurrent, and frequently changing physical symptoms persisting for at least two years. |
| F45.1 | Undifferentiated somatoform disorder | Physical complaints that are multiple, varying, and persistent but do not fulfil the complete criteria for somatisation disorder. |
| F45.2 | Hypochondriacal disorder | Persistent preoccupation with the possibility of having one or more serious and progressive physical disorders. |
| F45.3 | Somatoform autonomic dysfunction | Symptoms presented as if due to a physical disorder of a system or organ largely under autonomic innervation. |
| F45.4 | Persistent somatoform pain disorder | Persistent, severe, and distressing pain not fully explained by a physical disorder or physiological process. |
| F45.8 | Other somatoform disorders | Other specified somatoform conditions (e.g., psychogenic dysmenorrhoea, globus hystericus). |
| F45.9 | Somatoform disorder, unspecified | Somatoform disorder where the specific type is unspecified. |
Classification Boundaries
Includes
- Somatisation disorder
- Hypochondriacal disorder
- Somatoform autonomic dysfunction
- Persistent somatoform pain disorder
- Briquet disorder
- Multiple psychosomatic disorder
Excludes1 (coded elsewhere)
- Dissociative disorders (F44)
- Factitious disorders (F68.1)
- Hair-pulling (F63.3)
- Nail-biting (F98.8)
Excludes2 (may co-occur)
- Dermatitis factitia (L98.1)
- Psychological factors affecting physical conditions (F54)
Australian Clinical Context
Somatoform disorders are commonly encountered in Australian general practice. Management involves a collaborative approach between the GP, psychologist, and relevant medical specialists. The goal is to reduce unnecessary investigations while providing appropriate support and psychological intervention.
Medicare (MBS) Pathways
Better Access to Mental Health Care
The primary Medicare pathway for mental health treatment in Australia. Requires a GP Mental Health Treatment Plan (MHTP) referral. Available for any clinically diagnosed mental disorder.
10 individual + 10 group sessions per calendar year
| Provider Type | MBS Items | Session Type |
|---|---|---|
| Clinical Psychologist | 80000–80025 | Psychological therapy (higher rebate) |
| Registered Psychologist | 80100–80123 | Focused psychological strategies |
| Occupational Therapist | 80125–80145 | Focused psychological strategies |
| Social Worker | 80150–80175 | Focused psychological strategies |
| Psychiatrist | 291, 296–299, 300–308 | Psychiatric consultation |
GP referral items: 2700, 2701, 2715, 2717
Eligibility: Any clinically diagnosed mental disorder as defined by WHO ICD-10 Chapter V. Requires a GP or psychiatrist referral.
Exclusions:
- Intellectual disability (use Complex Neurodevelopmental Disorder pathway or specialist referral)
- Dementia and organic mental disorders (use specialist referral pathway)
- Tobacco use disorder
Grounded Scribe suggests the right MBS item codes from your recording so you can claim accurately without re-keying.
Reference information sourced from MBS Online (mbsonline.gov.au). Item availability, rebates, and eligibility criteria may change. This is not billing advice — always verify current items before claiming. Last verified: April 2026.
Clinical Documentation Notes
DSM-5-TR replaced "somatoform disorders" with "Somatic Symptom and Related Disorders," focusing on positive psychological features (excessive health-related thoughts, feelings, behaviours) rather than medically unexplained symptoms. Hypochondriacal disorder (F45.2) maps to Illness Anxiety Disorder in DSM-5-TR.
Related Diagnostic Codes
ICD-10-AM diagnostic codes commonly associated with the Somatoform Disorders (F45).
Frequently Asked Questions
What changed between somatoform disorders and DSM-5-TR somatic symptom disorder?
DSM-5-TR eliminated the requirement for symptoms to be "medically unexplained" and instead focuses on whether the person has disproportionate and persistent thoughts, feelings, or behaviours related to their somatic symptoms. This reflects the understanding that physical and psychological factors commonly coexist.
References
- World Health Organization. ICD-10-AM.
- American Psychiatric Association. DSM-5-TR. 2022.
This tool calculates scores based on published guidelines for professional reference. It does not provide clinical diagnoses. Scores are provided as reference information only and should be interpreted by a qualified practitioner in the context of a comprehensive assessment.
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