Am J Psychiatry /35:12. December 1978 1500 0002-953X/78/00I2- 1500$0.50 © 1978 American Psychiatric Association Hysteria Split Asunder

The authors present tile proposed DSM-III classifica tion of th e traditional hysterical disorders, i.e., disorders that suggest physical illness but in which p.s’ychologicalfactors arejudged to be of importance. The use ofthe DSM-III inclusion and exclusion criteria-physical mechanism explains the symptom, symptoms are linked to psychological f actors, symptom initiation is under voluntary control, and there is an obvious recognizable environmental goal-are discussed in the differential diagnosis of somatoform disorder, factitious disorder, malingering, psvchologicalf’actors affecting physical condition, and undiagnosed physical illness. THE PROPOSED draft of the American Psychiatric As-sociation’s Diagnostic and Statistical Manual of Men-tal Disorders (DSM-III) presents a new classification for the diagnosis of disorders that suggest physical ill-ness but in which psychological factors are judged to be of importance in the initiation, exacerbation, or maintenance of the disturbance. In DSM-II (1) many of these disorders were classified among the neuroses (e.g., hysterical, hypochondriacal, neurasthenic) or psychophysiologic disorders. In DSM-I1I conditions in which psychological factors are judged to be impor-tant, whether they are physical disorders, syndromes, or symptoms, are dissected and redefined according to certain fundamental distinctions. It is hoped that this will result in more reliable and valid diagnostic cate-gonies, not merely new theoretical explanations. TRADITIONAL CONCEPT OF HYSTERIA Traditionally the concept of hysteria included the following four criteria: the disturbance suggeste