Influence of Personality Disorders on Therapy Outcome in Somatoform Disorders at 2-Year Follow-up

The DSM-IV nosology of chronic pain: a comparison of pain disorder and multiple somatization syndrome.

This study evaluates the classification of pain from the perspective of the DSM-IV system. Of 60 in-patients with long-standing and disabling pain syndromes, 29 with pain disorder (PD) and 31 with pain as part of a multiple somatization syndrome (MSS) were compared before and after a structured cognitive-behavioral treatment. It was hypothesized that MSS patients show more psychological distress, are more severely disabled, and respond less to the treatment. Both groups were similar with respect to sociodemographic status, history of pain symptomatology and comorbidity with DSM-IV mental disorders. The results show that MSS patients had higher levels of affective and sensoric pain sensation…

Differentiating hypochondriasis from panic disorder

Hypochondriasis and panic disorder are both characterized by prevalent health anxieties and illness beliefs. Therefore, the question as to whether they represent distinct nosological entities has been raised. This study examines how clinical characteristics can be used to differentiate both disorders, taking the possibility of mixed symptomatologies (comorbidity) into account. We compared 46 patients with hypochondriasis, 45 with panic disorder, and 21 with comorbid hypochondriasis plus panic disorder. While panic patients had more comorbidity with agoraphobia, hypochondriasis was more closely associated with somatization. Patients with panic disorder were less pathological than hypochondri…

High utilizers of medical care

Abstract Objective Patients with somatoform disorders (SFD) are likely to overutilize healthcare services. This study investigates (a) whether extraordinarily high medical costs can be predicted from patient characteristics or psychopathology, and (b) whether high-utilizing patients respond differently to cognitive–behavioral treatment. Methods We compared 42 SFD high utilizers with 53 SFD average utilizers and 29 patients suffering from other than SFD mental disorders. High utilization was defined by healthcare expenditures of ≥€2500 during the past 2 years. Costs were computed from medical and billing records of health insurance companies. Somatization distress, hypochondriasis, depressio…

A controlled treatment study of somatoform disorders including analysis of healthcare utilization and cost-effectiveness.

Abstract Objective: The purpose of this prospective study was to evaluate the effects of cognitive-behavioral treatment (CBT) on mental health status and healthcare utilization in patients with somatoform disorders (SFD) of a specialized tertiary care center. Methods: According to DSM-IV interviews, 54 patients had somatization disorder (SD), 51 abridged somatization syndrome (SSI-8) and 67 other defined SFD. A clinical non-SFD comparison group consisted of 123 patients. Treatment effects were controlled against the waiting list. Cost calculations for the 2-year periods before and after treatment were based on medical and billing records from health insurance companies. Results: The SFD pat…

Shared genetic risk between eating disorder- and substance-use-related phenotypes: Evidence from genome-wide association studies

AbstractEating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa (BN) and problem alcohol use (genetic correlation [rg], twin-based=0.23-0.53). We estimated the genetic correlation between eating disorder and substance use and disorder phenotypes using data from genome-wide association studies (GWAS). Four eating disorder phenotypes (anorexia nervosa [AN], AN with binge-eating, AN without binge-eating, and a BN factor score), and eight substance-use-related phenotypes (drinks per week, alcohol use disorder [AUD], …

Kausalattributionen von körperlichen Beschwerden bei somatoformen Störungen

Zusammenfassung. Es wird angenommen, dass Patienten mit somatoformen Störungen überwiegend organmedizinisch-biologische Ursachen für ihre Beschwerden verantwortlich machen - und dass diese Attributionen an der Aufrechterhaltung der Störung beteiligt sind. Bislang wurden die Kausalattributionen nur selten und überwiegend mit Bestätigungsmethoden an somatoformen Störungen untersucht. Ziele der Studie waren die Identifikation der spontanen Ursachenzuschreibungen und der Prädiktoren des Attributionsstils bei Patienten mit somatoformen Störungen - sowie die Überprüfung der Auswirkung der Kausalattributionen auf den Therapieverlauf. Insgesamt wurden 79 Patienten einer psychosomatischen Klinik mi…

Searching for a Gastrointestinal Subgroup Within the Somatoform Disorders

The authors examined whether patients suffering from functional gastrointestinal symptoms constitute a separate group within the broader concept of the somatoform disorders. The authors compared 103 patients with a severe gastrointestinal syndrome, 220 patients with a somatization syndrome according to DSM-IV, and 250 clinical control subjects with nonsomatoform mental disorders. The gastrointestinal group showed more catastrophizing thinking, complained more about autonomic sensations, felt bodily weaker, was less tolerant towards bodily discomfort, had developed more hypochondriacal fears and behaviors, was more depressed, and was more severely disabled in different areas of psychosocial …

Hypochondriasis and somatization: two distinct aspects of somatoform disorders?

We investigated boundaries and overlap between somatization and hypochondriasis on different levels of psychopathology: (1) comorbidity between hypochondriasis and somatization on the level of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994): (2) comorbidity with other mental disorders; (3) differences in clinical characteristics: and (4) overlap on the level of psychometric measures. The sample consisted of 120 psycho somatic inpatients. Somatoform, hypochondriacal, and depressive symptomatology, cognitions about body and health, and further aspects of general symptomatology were investigated. Diagnoses …

Effect of comorbid anxiety, depressive, and personality disorders on treatment outcome of somatoform disorders

Comorbid mental disorders of DSM-IV axis I and axis II have repeatedly been found to be a negative predictor for the treatment of axis I disorders, although recent contrary findings exist. Little is known about the effect of comorbidity on the therapy outcome of somatoform disorders. We compared three types of comorbidity, (1) personality disorders (PDs), (2) major depression (MDD) and anxiety (ANX) disorders, and (3) PDS and MDD and ANX, with regard to their relevance for the treatment outcome of somatoform disorders. One hundred twenty-six inpatients were assessed at least 4 weeks before admission to treatment, upon admission, and again at discharge. Somatoform, hypochondriacal, and depre…