Medically unexplained cutaneous sensory symptoms may represent somatoform dissociation: an empirical study.
OBJECTIVE
We examined the relation between medically unexplained cutaneous symptoms and dissociation [measured by the Dissociative Experiences Scale, or DES; Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis 1986;174:727-35] among participants with no history of primary dermatologic disorders.


METHODS
Three hundred sixty consenting participants (44 psychiatric outpatients and 316 nonclinical participants from the community at large) rated the severity of nine medically unexplained cutaneous symptoms (sum of all ratings comprised the Cutaneous9 variable) and completed the DES.


RESULTS
The Cutaneous9 variable correlated significantly (Pearson r=.56, P<.001) with DES scores. Stepwise multiple regression analysis using the nine cutaneous symptoms as independent variables revealed that Pain, Itching, and Numbness were the best predictors of the DES scores (adjusted R2=.34, P<.001).


CONCLUSIONS
Our findings have empirically shown that itching, like pain and numbness, may be a symptom of somatoform dissociation. Second, even milder degrees of dissociation in the nonclinical range may play a role in the genesis of unexplained cutaneous sensory symptoms.
Gupta
Madhulika A
MA
Department of Psychiatry, University of Western Ontario, London, Ontario, Canada. magupta@uwo.ca
Gupta
Aditya K
AK
D000293:Adolescent; D000328:Adult; D000368:Aged; D015984:Causality; D015897:Comorbidity; D003291:Conversion Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D004213:Dissociative Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009450:Neurodermatitis / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010292:Paresthesia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010555:Personality Inventory; D011537:Pruritus / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012867:Skin / Q000294:innervation*; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires