Chronic Multisymptom Illness S025

Current RMA Instruments

Changes from previous Instruments

Brief description

Chronic multisymptom illness (CMI) is a condition characterised by multiple persistent somatic symptoms affecting more than one body system and resulting in significant functional impairment. 

Common symptoms may include fatigue, cognitive or mood-related symptoms, and musculoskeletal symptoms such as joint pain, joint stiffness or muscle pain. 

Confirming the diagnosis  

Diagnosis is established by clinical assessment and must be made by a specialist physician or psychiatrist. There is no specific laboratory test or imaging study that confirms the diagnosis. 

The diagnosis requires:

• one or more current symptoms from at least two of the following three symptom categories:

1. fatigue;
2. mood-cognition symptoms; and
3. musculoskeletal symptoms;

• symptoms causing significant disruption of social and occupational functioning;
• symptoms persisting for at least six consecutive months; and
• exclusion of alternative medical or psychiatric conditions that better explain the presentation

Additional diagnoses that may be covered by SOP

Nil

Conditions not covered by SOP 

It is important that symptoms are not better explained by another condition such as:

• Chronic fatigue syndrome *
• Dementia *
• Depressive Disorder *
• Dysthymic disorder *
• Fibromyalgia *
• Functional neurological symptom disorder #
• Generalised anxiety disorder *
• Gulf War Illness *
• Malignancy * or # 
• Other specified somatic symptom and related disorder #
• Pain disorder * or #

• Post-traumatic stress disorder *

   

* Another SOP applies

# Non-SOP condition

Clinical onset

Clinical onset is when the diagnostic criteria are first satisfied and confirmed by a relevant specialist. Clinical onset may be identified retrospectively once the six-month duration requirement has been met. 

Clinical worsening

The only clinical worsening factor is an inability to obtain appropriate clinical management before clinical worsening.