title: Psychosocial functioning in consultation-liaison psychiatry patients: influence of psychosomatic syndromes, psychopathology and somatization.
abstract: BACKGROUND
  This study investigated whether the Diagnostic Criteria for Psychosomatic Research (DCPR) were able to predict psychosocial functioning in addition to psychiatric diagnoses and somatization in consultation-liaison psychiatry (CLP) patients.
  
  
  METHODS
  A consecutive sample of 208 CLP patients were recruited and assessed for sociodemographic and medical data, psychopathology (SCID), psychosomatic syndromes (DCPR structured interview) and somatization (SCL-90-R SOM scale and multisomatoform disorder, MSD). The main endpoints were the mental and physical components of psychosocial functioning (SF-36).
  
  
  RESULTS
  A total of 185 (89%) patients had any psychiatric diagnosis, 51 (25%) had MSD positive criteria, 176 (85%) had any DCPR syndrome, and 105 (51%) had multiple DCPR syndromes. Although psychiatric and psychosomatic syndromes were variously associated with psychosocial functioning, hierarchical regression and effect size analyses showed that only DCPR syndromes, particularly demoralization and health anxiety, with somatization but not DSM-IV psychopathology independently predicted poor psychosocial functioning.
  
  
  CONCLUSIONS
  The presence of psychosomatic syndromes, assessed with DCPR criteria, and high levels of somatization had larger effect size and were independent predictors of the mental and physical components of psychosocial dysfunction, over and above psychopathology. The DCPR classification can provide CLP professionals with a set of sensitive diagnostic criteria for a comprehensive clinical evaluation of psychosomatic syndromes that might play a significant mediating role in the course and the outcome of medical patients referred for psychiatric consultation.
authors.affiliation: Psychosomatic Unit, IRCCS De Bellis Hospital, Via Turi, Castellana Grotte IT-70010, Italy. porcellip@media.it
authors.forename: Piero
authors.initials: P
authors.lastname: Porcelli
authors.forename: Antonello
authors.initials: A
authors.lastname: Bellomo
authors.forename: Roberto
authors.initials: R
authors.lastname: Quartesan
authors.forename: Mario
authors.initials: M
authors.lastname: Altamura
authors.forename: Salvatore
authors.initials: S
authors.lastname: Iuso
authors.forename: Ida
authors.initials: I
authors.lastname: Ciannameo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Piselli
authors.forename: Sandro
authors.initials: S
authors.lastname: Elisei
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D012017:Referral and Consultation; D012044:Regression Analysis; D012917:Social Adjustment; D012919:Social Behavior; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy