Suicidality in patients with somatoform disorder - the speechless expression of anger?
To identify emotion-associated risk factors for suicidality in patients with somatoform disorders.



A sample of 155 consecutive patients diagnosed with somatoform disorders at the Psychosomatic Ambulance of Bonn University Hospital filled in several questionnaires including the Symptom Checklist 90-Revised Version (SCL-90-R), the Toronto Alexithymia Scale (TAS-20), and the State Trait Anger Expression Inventory (STAXI). Our aim was to compare patients with suicide attempts to patients without suicide attempts via a MANCOVA (IV: Group; DV: SCL-90-R, TAS-20, STAXI; covariates: sex, age, depression, borderline personality disorder).



Lifetime suicide attempts were documented in 20 patients (12.9%), current active suicidal ideation in 33.6%, and thoughts of death or dying in 55.9%. Patients with lifetime suicide attempts showed significantly more psychological distress, a significantly higher alexithymia sum score, a significantly higher score on trait anger, state anger, and a stronger tendency to express anger.



Somatoform disorder patients with lifetime suicide attempts might have greater difficulties in identifying and describing emotions, and a tendency to intensely experience and express anger. Future longitudinal studies should further investigate possible links between difficulties in coping with anger and suicidality to improve prophylaxis and treatment of suicidal behaviour in somatoform disorder patients.
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany. Electronic address: nora.kaempfer@ukb.uni-bonn.de.
Nora
N
Kämpfer
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
Sabine
S
Staufenbiel
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
Ingo
I
Wegener
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
Stefanie
S
Rambau
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
Anne Sarah
AS
Urbach
Department of Palliative Medicine, University Hospital of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
Martin
M
Mücke
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
Franziska
F
Geiser
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
Rupert
R
Conrad
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000150:complications / Q000523:psychology; D000368:Aged; D000786:Anger / Q000502:physiology*; D001883:Borderline Personality Disorder / Q000150:complications / Q000523:psychology; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D012307:Risk Factors; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology*; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
Alexithymia; Anger; Somatoform disorder; Suicidality