Comorbidity of Somatoform Disorders
Author: Soliman H
Source:
The Egyptian Journal of Psychiatry, 1997, VOL 20,1:129-140
All patients presenting to the out- patient psychiatric clinic of El-Minia University hospital over a 4 month-period were screened for somatoform disorders (SDs). 92 Subjects (55 females & 37 males, mean age : 35,7) fulfilled criteria for SDs (ICD-10). The main diagnosis was undifferentiated somatoform disorder (USD) (76,6%), followed by somatization disorder (sd) (9,5%), persistent somatoform pain disorder PD (8,7%), hypochondriacal disorder (5,4%). The most frequent symptom was headache, followed by pains in the different body parts, autonomic manifestations, abdominal symptoms, conversion symptoms. A semistructured interview (SCAN) was used to assess psychiatric comorbidity. A concurrent psychiatric diagnosis was established in 85.9% of patients ; the commonest diagnosis was current depressive episode (58,7%) ; followed by anxiety disorders in 36,9% ; mixed anxiety-depression disorder (6,5%). More than one comorbid diagnosis was the case in 16,5% of the cases.
The total number of somatic symptoms was highest in somatization disorder and least in pain disorder, with undifferentiated somatoform and hypochondriacal disorder occupying an intermediate position. The number of somatic symptoms was highest in mixed anxiety depression disorder and least in patients with no comorbid diagnosis. It was also higher in moderate than in mild depressive episode, and in panic than in generalized anxiety disorder.
Depressed mood was correlated with pain symptoms, while anxiety correlated with autonomic manifestations. Three factors of somatic symptoms : conversion , GIT & pain were identified.
The results are discussed in the light of the current debate concerning comorbidity as well as the validity of the somatoform disorder category