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Clinical questions need perceptive answers
  1. M Swash
  1. Professor Emeritus at Queen Mary University of London (Barts and the London School of Medicine and Dentistry), and Honorary Professor of Neurology in the Faculty of Medicine, University of Lisbon, Portugal; mswash{at}btinternet.com

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There are several aspects of Christopher Ward’s editorial in the December issue1 with which one must take issue.

The first is his use of the technical psychiatric term “somatisation”, a word much used by some neurologists, but unfortunately almost always outside its tightly defined DSM IV context.2 Loose usage of a defined concept is never a productive way forward; it simply encourages a pejorative rather than a healing approach. Professor Ward follows this path by accusing neurologists of regarding functional symptoms as unreal. In this context, he uses the term “functional” to embrace symptoms not explained by a recognisable neurological (medical) illness, or considered by a physician as out of …

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