title: Complex post-traumatic stress disorder in patients with somatization disorder.
abstract: OBJECTIVE
  Given the association between severe childhood trauma, adult somatization and complex post-traumatic stress disorder (cPTSD), the purpose of the present paper was to assess this syndrome and its clinical correlates in patients with somatization disorder (SD).
  
  
  METHODS
  A total of 28 patients (82% women, mean age = 41.7+/-10.1 years) meeting DSM-IV criteria for SD as confirmed by the Structured Clinical Interview for DSM-IV, Axis I were compared to 28 age- and gender-matched patients with major depression, but without a lifetime diagnosis of SD. They completed the Structured Interview for Disorders of Extreme Stress, the Brief Symptom Inventory, the Inventory of Interpersonal Problems-Circumplex Scales, and the SF-36 Health Survey.
  
  
  RESULTS
  Compared to the control group, SD patients had higher risks for current and lifetime diagnoses of cPTSD (odds ratio (OR) = 15.0, 95% confidence interval (CI) = 1.76-127.54; and OR = 8.33, 95%CI = 2.04-34.07, respectively). SD subjects with cPTSD had more psychological distress, more interpersonal problems and worse psychosocial functioning than those without the syndrome.
  
  
  CONCLUSIONS
  The concept of complex PTSD may hold clinical utility when applied to SD patients because it identifies a distinct subgroup characterized by severe psychosocial impairment. The diagnostic and therapeutic implications of the present findings are discussed.
authors.affiliation: University Department of Psychosomatic Medicine and Psychotherapy, University Clinic Hamburg-Eppendorf and Klinikum Eilbek (Schön Kliniken), Hamburg, Germany. c.spitzer@uke.uni-hamburg.de
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.forename: Sven
authors.initials: S
authors.lastname: Barnow
authors.forename: Katja
authors.initials: K
authors.lastname: Wingenfeld
authors.forename: Matthias
authors.initials: M
authors.lastname: Rose
authors.forename: Bernd
authors.initials: B
authors.lastname: Löwe
authors.forename: Hans Joergen
authors.initials: HJ
authors.lastname: Grabe
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005858:Germany; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D011599:Psychopathology; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology