Characteristics of oligosymptomatic versus polysymptomatic presentations of somatoform disorders in patients with suspected allergies.
OBJECTIVE
Psychobehavioral characteristics of patients with somatoform disorders (SFDs), are increasingly discussed as possible positive criteria for this diagnostic group. However, little is known about psychobehavioral differences, or similarities, between the different SFD presentations, i.e., polysymptomatic [multisomatoform/somatization disorders (MSD)] versus mono- or oligosymptomatic courses [pain disorder (PD), undifferentiated somatoform disorder (USD)].


METHODS
This is a cross-sectional study including 268 consecutive allergology inpatients. After an Structured Clinical Interview for DSM-IV, patients completed several self-rating questionnaires. Results were compared within the different SFD presentations as well as between patients with versus without SFDs.


RESULTS
We identified 72 patients with an SFD. There were fewer and smaller psychobehavioral differences within patients with the different SFD presentations (MSD, USDs, PDs) than between patients with undifferentiated versus no SFD. Patients with one of the three different SFD subdiagnoses scored similarly on many measures referring to psychosocial distress (e.g., psychological distress, mental health-related quality of life, dissatisfaction with care). The number of reported symptoms, somatic symptom severity, a self-concept of bodily weakness, the degree of disease conviction, and physical health-related quality of life discriminated the different SFD presentations not only from patients without SFDs but also from each other.


CONCLUSIONS
Patients diagnosed with one of the different SFD subtypes share many psychobehavioral characteristics, mostly regarding the reporting of psychosocial distress. Perceived somatic symptom severity and physical impairment as indicators of bodily distress could either further define categorical subdivisions of SFD or dimensionally graduate one general SFD category defined by bothering bodily symptoms and disproportionate psychosocial distress.
Hausteiner
Constanze
C
Department of Psychosomatic Medicine and Psychotherapy, Technische Universitaet Muenchen, Langerstrasse 3, Munich, Germany. c.hausteiner@lrz.tum.de
Huber
Dorothea
D
Bornschein
Susanne
S
Grosber
Martine
M
Bubel
Esther
E
Groben
Sylvie
S
Lahmann
Claas
C
Löwe
Bernd
B
Eyer
Florian
F
Eberlein
Bernadette
B
Ring
Johannes
J
Behrendt
Heidrun
H
Darsow
Ulf
U
Henningsen
Peter
P
D000328:Adult; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000145:classification* / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires