Persistent somatization in cancer: a controlled follow-up study.
Nature and frequency of somatic complaints, severity of anxiety and depression, and nature of psychiatric symptoms and disorders were evaluated in 81 adequately treated cancer patients, disease-free or with residual disease, using a controlled, prospective follow-up design. Patients were included in the index group (n=60) if they had persistent somatic complaints or unexplained nature or severity of somatic complaints, or the control group (n=21), if they did not report somatic complaints. Instruments used for evaluation were the Scale for Assessment of Somatic Symptoms, Hospital Anxiety and Depression Scale, Psychiatric Assessment Schedule, and DSM-III-R. Common somatic complaints in the index group were pain (19%), fatigue (17%), sensory symptoms (30%), and mixed symptoms (27%). Subjects in the index group significantly (p<0.001) more often had depressive or anxiety disorder (19%) and atypical somatoform disorder (15%). Patients were treated appropriately with psychotropic medications and counseling. Follow-up at 4-6 months revealed a significant reduction in the number of somatic symptoms (p<0.001) and anxiety (p<0.001) and depression (p<0.05) scores. The observations confirm that somatic symptoms may persist in cancer patients, which are related to concomitant psychopathology, and require psychiatric intervention.
Cancer Research Campaign, Psychological Medicine Group, Christie Hospital, Manchester, UK. chatur@nimhans.ren.nic.in
S K
SK
Chaturvedi
G P
GP
Maguire
D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010146:Pain / Q000209:etiology / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis / Q000209:etiology*