2018
Volume 18, Number 2, pp. 67–77
Bodily distress syndrome: Concerns about scientific credibility in research and implementation
Diane O’Leary1, 2
1 Rotman Institute of Philosophy, Western University, London, Ontario, Canada
2 Fondation Brocher, Hermance, Switzerland
The credibility of psychosomatic medicine has recently been called into question through challenges to the scientific integrity of the “PACE trial”, which claimed success for psychiatric treatment in managing myalgic encephalomyelitis/chronic fatigue syndrome. The newest product of research in psychosomatic medicine is “bodily distress syndrome” (BDS), a Danish diagnostic construct developed to replace “somatoform disorders”, “medically unexplained symptoms” and “functional somatic syndromes”. I set out in this paper to examine the science that supports the construct of BDS, both in design and in implementation. Following the Introduction, in §2 I clarify the details that define BDS and the problems the construct is designed to resolve. In §3 I explore three problems with the science behind BDS. In §4 I consider the World Health Organization (WHO)’s effort to implement BDS in the International Classification of Diseases (ICD), noting that while BDS criteria fail in both WHO studies, the workgroup nonetheless insists that the ICD should recommend them for global use. I conclude that BDS gives support to recent concern that scientific standards in psychosomatic medicine are inadequate, closing with a brief discussion of ethical problems that arise when global health policy decisions are not grounded in science.
Keywords: evidence-based medicine, International Classification of Diseases, myalgic encephalomyelitis/chronic fatigue syndrome, psychosomatic medicine, scientific integrity