The collaborative has also developed a web-based, interactive decision support tool that utilizes empirical evidence about the predictors of screening to deliver tailored information designed to improve readiness to screen. Pilot data highlight the potential utility of this approach. They document the prevalence of internet use and acceptability in the target age group, establish the validity of the social cognitive variables included in the decision support tool as correlates of Australians' readiness to screen for bowel cancer, and demonstrate within the laboratory, the greater effectiveness of tailored compared with generic messages. Medically unexplained physical symptoms are a major challenge not only for the general health care system, but also for the development of reliable and valid classification approaches and effective interventions. A revision of the classification of somatoform disorders seems necessary, although there is continuing discussion what should be revised in detail. Joel Dimsdale, the speaker of the DSM-V work group, will present the latest DSM-V proposal for the classification of somatic symptoms causing significant psychological distress, and empirical data supporting this new classification approach. Per Fink and colleagues will provide data from Denmark indicating one new approach to tackle diagnostic problems of somatoform disorders, and its empirical validation. New frontiers of interventions are reported by A. Schröder who focus on functional somatic symptoms. The presentation of Arthur Barsky will finally address the different nature of somatic symptoms, and especially the distinction between nonpathological bodily discomfort versus psychopathological features that need to be diagnosed. The symposium will result in a discussion of future options for classification and treatment of this prevalent and costly medical condition. Medically unexplained somatic symptoms may result from many sources other than psychiatric disorder, and somatization therefore is not by definition psychopathological. Such symptoms are a final common pathway for the expression of situational, intrapsychic, behavioral, interpersonal and sociocultural distress. Symptoms without a serious medical cause are a nearly universal human experience, arising in the daily lives of perfectly healthy people. Some are a non-verbal interpersonal communication in which the individual seeks the acknowledgment from others that they are in distress and suffering, hoping thereby to secure special attention, support, and consideration. For some patients, a lifetime of medically unexplained complaints can be best conceptualized as a stable personality trait, one that has been associated with other enduring personality characteristics. Somatization can also be understood as a form of illness and sick role behaviornot something an individual has, but rather something he/she does. Alternatively, emotional distress, particularly when combined with certain early childhood experiences of trauma, adversity or deprivation, can generate somatic symptoms. Preoccupied and fearful attachment styles that are learned in childhood can also lead to somatization in adulthood. The presentation of medically unexplained symptoms is also subject to socio-cultural influences. Cultural norms and values encourage the expression of distress in certain forms and discourage it in others; these cultural forces shape the experience and reporting of bodily symptoms by influencing how they are identified, interpreted, described and reported. Finally, the search for neurobiological mechanisms of somatization is under way, implicating the hyperresponsivity of centrally acting proinflammatory cytokines, dysregulation of central and peripheral serotonergic systems, and dysregulation of the hypothalamic-pituitary-adrenal axis. It is only when these medically unexplained symptoms are recurrent, especially distressing, severe, prolonged, and disabling that they may be considered psychopathological. Background: Functional somatic syndromes (FSS) such as fibromyalgia or irritable bowel syndrome are highly prevalent and may be persistent and disabling for patients and costly to services. We assessed the efficacy of a cognitive behavioral group treatment (STreSS) for patients with a variety of severe FSS in improving physical health. Methods: Patients aged 20-45 year with chronic, disabling FSS or somatoform disorders who met criteria for the unifying diagnosis of severe, multi-organ Bodily distress syndrome were eligible for this randomized trial at a General University Hospital. 120 patients were randomly assigned by means of a computer-assisted block protocol to a cognitive behavioral group treatment (54 patients) or to enhanced usual medical care (66 patients). The primary outcome was the difference in change from baseline to 16 months in the SF-36 Perceived Physical Health (PPH) score between the two groups. Analysis was by intention to treat. Results: 44 patients in the STreSS group and 50 in the comparison group completed follow-up at 16 months. By use of repeated measures mixed effects modeling and multiple imputation, all 120 participants were included in the analysis. The adjusted mean difference in PPH score change from baseline to 16 months was 4.1 (95 % CI 1.5-6.7, p=0.002), a moderate effect size (0.51; [0.19-0.83]). The number needed to treat to achieve one additional treatment response was 5 (3-53, p=0.03). Conclusion: Specialized Treatment for Severe Bodily Distress Syndromes (STreSS) provides a promising model for the management of patients with various severe FSS. Our approach may be a feasible alternative to the current organization of care in many different medical specialties.