Big Five personality traits and medically unexplained symptoms in later life.
Personality dysfunction has been postulated as the most clinically salient problem of persons suffering from medically unexplained symptoms (MUS) but empirical studies are scarce. This study aims to compare the personality profile of older patients suffering from MUS with two comparison groups and a control group.



Ninety-six older patients with MUS were compared with 153 frequent attenders in primary care suffering from medically explained symptoms (MES), 255 patients with a past-month depressive disorder (DSM-IV-TR), and a control group of 125 older persons. The Big Five personality domains (NEO-Five-Factor Inventory) were compared between groups by multiple ANCOVAs adjusted for age, sex, education, partner status and cognitive functioning. Linear regression analyses were applied to examine the association between health anxiety (Whitley Index) and somatization (Brief Symptom Inventory).



The four groups differed with respect to neuroticism (P<0.001), extraversion (P<0.001), and agreeableness (P=0.045). Post hoc analyses, showed that MUS patients compared to controls scored higher on neuroticism and agreeableness, and compared to depressed patients lower on neuroticism and higher on extraversion as well agreeableness. Interestingly, MUS and MES patients had a similar personality profile. Health anxiety and somatization were associated with a higher level of neuroticism and a lower level of extraversion and conscientiousness, irrespective whether the physical symptom was explained or not.



Older patients with MUS have a specific personality profile, comparable to MES patients. Health anxiety and somatization may be better indicators of psychopathology than whether a physical symptom is medically explained or not.
University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), PO box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: s.d.m.van.dijk@umcg.nl.
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SD
van Dijk
Radboud University Nijmegen Medical Center, Department of Psychiatry & Research Institute for Health Sciences, Nijmegen, The Netherlands.
D
D
Hanssen
Radboud University Nijmegen Medical Center, Department of Psychiatry & Research Institute for Health Sciences, Nijmegen, The Netherlands; Department of Old Age Psychiatry, GGNet, Apeldoorn, The Netherlands.
P
P
Naarding
Radboud University Nijmegen Medical Center, Department of Primary and Community Care, Nijmegen, The Netherlands.
P
P
Lucassen
GGZinGeest & Department Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
H
H
Comijs
University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), PO box 30.001, 9700 RB Groningen, The Netherlands.
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R
Oude Voshaar
D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D000071896:Medically Unexplained Symptoms; D008603:Mental Health; D008875:Middle Aged; D000075384:Neuroticism; D010551:Personality; D010555:Personality Inventory; D011320:Primary Health Care; D012044:Regression Analysis
Big Five personality; DSM-5; Depressed elderly; Medically unexplained symptoms; Older adults; Somatoform disorder