title: Somatization is associated with physical health-related quality of life independent of anxiety and depression in cancer, glaucoma and rheumatological disorders.
abstract: OBJECTIVE
  To test the relative importance of anxiety, depression and somatization as correlates of physical health-related quality of life (HRQOL) in several chronic physical disorders.
  
  
  METHODS
  In a cross-sectional study of patients with colorectal cancer (N = 162), glaucoma (N = 100), rheumatoid arthritis (N = 168), systemic sclerosis (N = 56) and systemic lupus erythematosus (N = 56), we assessed specific disease severity and used the Symptom Distress Checklist (SCL-90) for psychologic dimensions. Outcome was assessed with the WHO Quality of Life Instrument, Short Form using hierarchical regression to determine independent correlates of HRQOL.
  
  
  RESULTS
  After adjustment for demographic features, stage of cancer and pain (final models), the SCL-90 somatization score was the only psychologic distress covariate significantly correlated to physical HRQOL in all diseases (Betas between -0.33 and -0.49) except in systemic sclerosis and scleroderma, where depression was also a correlate. In glaucoma patients, the SCL-90 somatization score was the only significant covariate for physical HRQOL in the final model.
  
  
  CONCLUSIONS
  Since reported number of bodily symptoms is both associated with physical HRQOL and treatable in its own right, our findings suggest a possible new avenue to improve the HRQOL in patients with chronic physical disease. Whether this offers greater benefit than treatments for anxiety and depression needs further research.
authors.affiliation: Department of Psychiatry, Medical School, University of Ioannina, 45110, Ioannina, Greece. tyfantis@cc.uoi.gr
authors.forename: Thomas
authors.initials: T
authors.lastname: Hyphantis
authors.forename: Barbara
authors.initials: B
authors.lastname: Tomenson
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Paika
authors.forename: Augoustina
authors.initials: A
authors.lastname: Almyroudi
authors.forename: Chrisavgi
authors.initials: C
authors.lastname: Pappa
authors.forename: Niki
authors.initials: N
authors.lastname: Tsifetaki
authors.forename: Paraskevi V
authors.initials: PV
authors.lastname: Voulgari
authors.forename: Alexandros A
authors.initials: AA
authors.lastname: Drosos
authors.forename: Nicholas
authors.initials: N
authors.lastname: Pavlidis
authors.forename: Francis
authors.initials: F
authors.lastname: Creed
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005901:Glaucoma / Q000150:complications*; D006305:Health Status Indicators; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009369:Neoplasms / Q000150:complications*; D010147:Pain Measurement; D011594:Psychometrics; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000150:complications*; D013001:Somatoform Disorders / Q000453:epidemiology* / Q000209:etiology; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
references.citation: Clin Exp Rheumatol. 2005 Nov-Dec;23(6):783-8
references.pmid: 16396695
references.citation: Qual Life Res. 2004 Mar;13(2):299-310
references.pmid: 15085902
references.citation: Psychooncology. 2007 Nov;16(11):1046-9
references.pmid: 17506074
references.citation: J Rheumatol. 1990 Aug;17(8):1016-21
references.pmid: 2213776
references.citation: Int Rev Psychiatry. 2006 Feb;18(1):49-54
references.pmid: 16451880
references.citation: Gen Hosp Psychiatry. 2007 Mar-Apr;29(2):147-55
references.pmid: 17336664
references.citation: Arthritis Rheum. 2008 Feb;58(2):456-66
references.pmid: 18240240
references.citation: J Psychosom Res. 2000 Jul;49(1):27-34
references.pmid: 11053601
references.citation: Int J Clin Oncol. 2005 Dec;10(6):411-7
references.pmid: 16369745
references.citation: Arch Gen Psychiatry. 2005 Aug;62(8):903-10
references.pmid: 16061768
references.citation: Clin Exp Rheumatol. 2003;21(3 Suppl 29):S19-23
references.pmid: 12889217
references.citation: Psychol Med. 1998 May;28(3):551-8
references.pmid: 9626712
references.citation: Curr Opin Ophthalmol. 2003 Apr;14(2):100-5
references.pmid: 12698051
references.citation: Scand J Rheumatol. 2006 May-Jun;35(3):175-81
references.pmid: 16766363
references.citation: J Glaucoma. 2007 Sep;16(6):513-20
references.pmid: 17873711
references.citation: J Clin Epidemiol. 2003 Mar;56(3):221-9
references.pmid: 12725876
references.citation: Arch Gen Psychiatry. 1997 Apr;54(4):352-8
references.pmid: 9107152
references.citation: Clin Exp Rheumatol. 2003;21(3 Suppl 29):S29-31
references.pmid: 12889219
references.citation: Am J Gastroenterol. 2002 Aug;97(8):1994-9
references.pmid: 12190166
references.citation: Ann Oncol. 2005 May;16(5):805-16
references.pmid: 15817599
references.citation: Arthritis Rheum. 1992 Jun;35(6):630-40
references.pmid: 1599520
references.citation: Arthritis Rheum. 2004 Jun 15;51(3):350-7
references.pmid: 15188318
references.citation: Inflamm Bowel Dis. 2008 Jul;14(7):977-83
references.pmid: 18275078
references.citation: J Rheumatol. 1995 Jul;22(7):1281-5
references.pmid: 7562759
references.citation: Brain Res. 2007 Nov 14;1180:7-19
references.pmid: 17935703
references.citation: J Chronic Dis. 1987;40(5):373-83
references.pmid: 3558716
references.citation: Aust N Z J Psychiatry. 2005 Sep;39(9):807-15
references.pmid: 16168039
references.citation: Support Care Cancer. 2007 Jan;15(1):21-30
references.pmid: 16738906
references.citation: J Psychosom Res. 2008 Jun;64(6):613-20
references.pmid: 18501262
references.citation: Dig Dis Sci. 2010 Mar;55(3):724-32
references.pmid: 19255844
references.citation: Arch Ophthalmol. 1992 Jun;110(6):820-6
references.pmid: 1596231
references.citation: Am J Ophthalmol. 2007 Aug;144(2):238-244
references.pmid: 17560843
references.citation: J Rheumatol. 2003 Jan;30(1):167-78
references.pmid: 12508408
references.citation: J Clin Oncol. 2002 Jul 15;20(14):3137-48
references.pmid: 12118028
references.citation: Psychosomatics. 2001 May-Jun;42(3):261-8
references.pmid: 11351117
references.citation: Psychosom Med. 2002 Mar-Apr;64(2):258-66
references.pmid: 11914441
references.citation: Palliat Med. 2003 Sep;17(6):509-13
references.pmid: 14526884
references.citation: Arthritis Rheum. 1988 Mar;31(3):315-24
references.pmid: 3358796
references.citation: Semin Arthritis Rheum. 2007 Oct;37(2):81-92
references.pmid: 17512572
references.citation: Arthritis Rheum. 1997 Sep;40(9):1725
references.pmid: 9324032
references.citation: J Psychosom Res. 2006 Nov;61(5):609-17
references.pmid: 17084138
references.citation: Aliment Pharmacol Ther. 2005 Mar 1;21(5):499-508
references.pmid: 15740531
references.citation: J Psychosom Res. 2007 Dec;63(6):673-81
references.pmid: 18061759
references.citation: J Psychosom Res. 2006 Apr;60(4):357-63
references.pmid: 16581359
references.citation: Qual Life Res. 2007 Nov;16(9):1483-9
references.pmid: 17899448
references.citation: J Psychosom Res. 1998 Sep;45(3):249-56
references.pmid: 9776370
references.citation: Arthritis Rheum. 1980 May;23(5):581-90
references.pmid: 7378088
references.citation: Arthritis Rheum. 2002 Jun 15;47(3):333-42
references.pmid: 12115165
references.citation: Clin Rheumatol. 2005 Feb;24(1):48-54
references.pmid: 15300468
references.citation: Psychooncology. 2008 Jan;17(1):26-33
references.pmid: 17328030
references.citation: Arthritis Rheum. 1995 Jan;38(1):44-8
references.pmid: 7818570
references.citation: Arch Pathol Lab Med. 2000 Jul;124(7):979-94
references.pmid: 10888773
references.citation: J Psychosom Res. 2008 Oct;65(4):311-7
references.pmid: 18805239
references.citation: Clin Exp Rheumatol. 2003;21(3 Suppl 29):S15-8
references.pmid: 12889216
references.citation: Psychosom Med. 2007 Dec;69(9):881-8
references.pmid: 18040099
references.citation: J Psychosom Res. 2008 Nov;65(5):417-24
references.pmid: 18940371