title: Course and prediction of somatoform disorder and medically unexplained symptoms in primary care.
abstract: THEORY/OBJECTIVE: Somatoform disorder (SFD) is associated with considerable psychosocial impairment. However, only a few studies have dealt with the course of this clinical subgroup. Therefore, the objective was to identify predictors for the various courses of SFD and medically unexplained symptoms (MUS).
  
  
  METHODS
  We screened 620 consecutive patients in primary care using the Patient Health Questionnaire (PHQ-15). Afterwards, 308 patients were studied in more detail using a diagnostic interview and a set of questionnaires. One year later, we were able to interview 277 participants a second time.
  
  
  RESULTS
  After 1 year, 48.8% of the respondents had a remitted SFD. The following variables proved to be significant predictors of MUS: current depressive episode, negative life events, number of MUS at baseline, attributional style, autonomic sensations and catastrophizing cognitions. The course of SFD could be predicted through current depressive or anxiety disorder, negative life events, functional disability and attributional style.
  
  
  CONCLUSIONS
  Somatoform disorder has a favorable course. The predictors of the courses of SFD and MUS we found can be integrated into previous explanatory models. The coping with MUS or SFD can be seen as a mediating factor.
authors.affiliation: Department of Clinical Psychology, Johannes Gutenberg-University of Mainz, 55122 Mainz, Germany. steinbrn@uni-mainz.de
authors.forename: Natalie
authors.initials: N
authors.lastname: Steinbrecher
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hiller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D013001:Somatoform Disorders / Q000209:etiology* / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D055815:Young Adult