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Subjective dizziness is defined as non-vertigo dizziness that persists after exclusion of medical causes. It is seen frequently in patients with anxiety and other stress-related disorders, but also in functional somatic syndromes. Mild and moderate cases do not need specific treatment, but underlying factors may need attention, e.g. anxiety or stress. Treatment of chronic cases should be focused on perpetuating factors such as catastrophising and avoidance behaviour. Cognitive therapy, with or without vestibular rehabilitation, is effective, while evidence for antidepressants is limited.

Identical treatment strategies have proven effective in various functional somatic syndromes (FSS) and evidence is increasing that FSS share common aetiological factors, pathophysiological mechanisms and psychological features. Currently, only a minority of patients with FSS receive evidence-based treatment. The main reasons for this are inappropriate organisation of care, physicians' lack of knowledge and a widespread neglect of patients' suffering. We outline a unified stepped care approach for the prevention and management of FSS in which treatment strategies are not based on the diagnostic label, but on illness severity and complexity.

Functional somatic symptoms are prevalent in all medical settings, but their management is hampered by an obsolete theoretical framework and inadequate classification systems. Epidemiological and neurobiological studies suggest that the functional somatic syndromes, e.g. fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome and somatoform disorders belong to the same family of disorders. An empirically based diagnosis including different subtypes and severities is proposed as a unifying diagnostic construct: bodily distress syndrome. This construct provides a common language for functional disorders across medical specialties.