Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-29T20:46:38.794Z Has data issue: false hasContentIssue false

Somatoform disorders in patients with musculoskeletal and cardiovascular diseases in comparison to the general population

Published online by Cambridge University Press:  24 June 2014

Harald Baumeister*
Affiliation:
Department of Psychiatry and Psychotherapy, Freiburg University Medical Center, Freiburg, Germany
Martin Härter
Affiliation:
Department of Psychiatry and Psychotherapy, Freiburg University Medical Center, Freiburg, Germany
*
Harald Baumeister MA, Department of Psychiatry and Psychotherapy, Freiburg University Medical Center, Hauptstrasse 5, D-79104 Freiburg, Germany. Tel: +49 761290-9539; Fax: +49 761290-9527; E-mail: [email protected]

Abstract

Objective:

The present epidemiological study investigates sex- and age-adjusted 4-week, 12-month, and lifetime prevalence rates of somatoform disorders in in-patients with musculoskeletal and cardiovascular diseases in comparison with prevalence rates of these disorders in the general population in Germany.

Methods:

Prevalence rates were calculated from two samples, one from rehabilitation in-patients with musculoskeletal (n = 187) or cardiovascular (n = 116) diseases, and one from a large sample of the German National Health Interview and Examination Survey – Mental Health Supplement (GHS-MHS; n = 3889). The prevalence rates were based on the M-CIDI, an interview for the assessment of mental disorders.

Results:

The adjusted prevalence rates of any mental disorder in both clinical samples are higher compared with rates of the general population (e.g. lifetime musculoskeletal, 59.3%; cardiovascular, 56.2%; general population, 47.9%). Prevalence rates of patients with cardiovascular (e.g. 12.2%) and musculoskeletal (21.5%) diseases do not indicate an increased prevalence of somatoform disorders compared with the general population (18.2%).

Conclusions:

The results confirm that patients with chronic somatic diseases have increased prevalence rates of mental disorders. However, these increased prevalence rates go primarily back to affective and anxiety disorders and not to somatoform disorders. The diagnostic criteria for somatoform disorders and the question algorithm of the M-CIDI are probably responsible for potential underestimation of somatoform disorders in patients with chronic somatic diseases.

Type
Research Article
Copyright
Copyright © 2003 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hansen, MS, Fink, P, Frydenberg, M, Oxhoj, M, Sondergaard, L, Munk-Jorgensen, P. Mental disorders among internal medical inpatients: prevalence, detection, and treatment status. J Psychosom Res 2001;50: 199204.CrossRefGoogle ScholarPubMed
Härter, M, Reuter, K, Weisser, B, Schretzmann, B, Aschenbrenner, A, Bengel, J. A descriptive study of psychiatric disorders and psychosocial burden in rehabilitation patients with musculoskeletal diseases. Arch Phys Med Rehabil 2002;83: 461468.CrossRefGoogle ScholarPubMed
Magni, G, Marchetti, M, Moreschi, C, Merskey, H, Lucchini, SR. Chronic musculoskeletal pain and depressive symptoms in the national health and nutrition examination. I. Epidemiologic follow-up study. Pain 1993;53: 163168.CrossRefGoogle ScholarPubMed
Wells, KB, Golding, JM, Burnam, MA. Psychiatric disorder in a sample of the general population with and without chronic medical conditions. Am J Psychiatry 1988;145: 976981.Google Scholar
Wells, KB, Golding, JM, Burnam, MA. Affective, substance use, and anxiety disorders in persons with arthritis, diabetes, heart disease, high blood pressure, or chronic lung conditions. General Hosp Psychiatry 1989;11: 320327. CrossRefGoogle ScholarPubMed
Isaac, M, Janca, A, Burke, KCet al. Medically unexplained somatic symptoms in different cultures. Psychother Psychosom 1995;64: 8893.CrossRefGoogle ScholarPubMed
Ladwig, Kh, Marten-Mittag, B, Erazo, N, Gündel, H. Identifying somatization disorder in a population-based health examination survey. Psychosocial burden and gender differences. Psychosomatics 2001;42: 511518.CrossRefGoogle Scholar
Härter, M, Bengel, J. Epidemiologie Psychischer Störungen in der Medizinischen Rehabilitation [Epidemiology of mental disorders in medical rehabilitation]. Final Report (unpublished) (01 GD 9802/4). Freiburg: University of Freiburg, 2001. Google Scholar
Jacobi, F, Wittchen, HU, Müller, Net al. Estimating the prevalence of mental and somatic disorders in the community. Aims and methods of the German National Health Interview and Examination Survey. Int J Meth Psychiatr Res 2002;11: 118. CrossRefGoogle ScholarPubMed
Goldberg, D, Williams, P. A User's Guide to the General Health Questionnaire. Windsor: NFER-Nelson, 1988. Google Scholar
Wittchen, HU, Weigel, A, Pfister, H. DIA-X – Diagnostisches Expertensystem [DIA-X – diagnostic expert system]. Frankfurt: Swets Test Services, 1996. Google Scholar
World Health Organization (WHO). Composite International Diagnostic Interview (CIDI), Version 1.0. Geneva: World Health Organization, 1990. Google Scholar
World Health Organization (WHO). Composite International Diagnostic Interview (CIDI), Version 2.1. Geneva: World Health Organization, 1997. Google Scholar
Wittchen, HU, Robins, LN, Cottler, LB, Sartorius, N, Burke, JD, Regier, D, participants of theWHO/ADAMHA field trials. Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI) – Results of the multicenter WHO/ADAMHA field trials (Wave I). Br J Psychiatry 1991;159: 645653.CrossRefGoogle Scholar
World Health Organization (WHO). ICD-10 Classification of Mental and Behavioural Disorders with Glossary and Diagnostic Criteria for Research ICD-10: DCR-10. Geneva: World Health Organization, 1991. Google Scholar
Wittchen, HU, Pfister, H. Instruktionsmanual zur Durchführung von DIA-X-Interviews [Instruction Manual for Executing DIA-X-Interviews]. Frankfurt: Swets Test Services, 1997. Google Scholar
Statacorp. Stata Statistical Software, Release 7.0. College Station, TX: Stata Corporation, 2001. Google Scholar
VDR (Verband Deutscher Rentenversicherungsträger). VDR Statistik Rehabilitation. Leistungen zur Rehabilitation und zusätzliche Leistungen der gesetzlichen Rentenversicherung im Jahr 1999 [VDR Statistics Rehabilitation]. Frankfurt: VDR, 2000. Google Scholar
Härter, M, Baumeister, H, Reuter, K, Wunsch, A, Bengel, J. Epidemiologie komorbider psychischer Störungen bei Rehabilitanden mit muskuloskelettalen und kardiovaskulären Erkrankungen [Epidemiology of comorbid mental disorders in patients with musculoskeletal and cardiovascular diseases]. Rehabilitation 2002; 41: 367374.CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and Statistic Manual of Mental Disorders, 4th edn. Washingtion, DC: American Psychiatric Press, 1994. Google ScholarPubMed
Peveler, R, Kilkenny, L, Kinmonth, AL. Medically unexplained physical symptoms in primary care. a comparison of self-report screening questionnaires and clinical opinion. J Psychosom Res 1997;42: 245252.CrossRefGoogle ScholarPubMed
Wittchen, HU. Schlussbericht Zusatzsurvey ‘Psychische Störungen’ (Bundesgesundheitssurvey ‘98): Häufigkeit, psychosoziale Beeinträchtigungen und Zusammenhänge mit körperlichen Erkrankungen. Teil 2: Tabellenband (Grundauszählung und Anleitung Public Use File).[Final report GHS-MHS]. Bonn: Bundesministerium für Bildung und Forschung, 2000. Google Scholar
Robins, LN, Regier, D. Psychiatric Disorders in America: the Epidemiologic Catchment Area Study. New York: Free Press, 1991. Google Scholar
Escobar, JI. Overview of somatization: diagnosis, epidemiology, and management. Psychopharmacol Bull 1996;32: 589596.Google ScholarPubMed
Faravelli, C, Salvatori, S, Galassi, F, Aiazzi, L, Drei, C, Cabras, P. Epidemiology of somatoform disorders: a community survey in Florence. Soc Psychiatry Psychiatr Epidemiol 1997;32: 2429.CrossRefGoogle ScholarPubMed
Andrews, G, Henderson, S, Hall, W. Prevalence, comorbidity, disability and service utilisation. Br J Psychiatry 2001;178: 145153.CrossRefGoogle ScholarPubMed
Bijl, RV, Ravelli, A, Van Zessen, G. Prevalence of psychiatric disorder in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 1998;33: 587595.CrossRefGoogle Scholar
Jenkins, R, Lewis, G, Bebbington, Pet al. The National Psychiatric Morbidity Survey of Great Britain – initial findings from the Household Survey. Psychol Med 1997;27: 775789.CrossRefGoogle ScholarPubMed
Kessler, RC, McGonagle, KA, Zhao, Set al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 1994;51: 819.CrossRefGoogle ScholarPubMed
Kirmayer, LJ, Young, A. Culture and somatization: clinical, epidemiological, and ethnographic perspectives. Psychosom Med 1998;60: 420430.CrossRefGoogle ScholarPubMed
Goldberg, D, Lecrubier, Y. Form and frequency of mental disorders across centres. In: ÜStün, TB, Sartorius, N, eds. Mental Illness in General Health Care. Chichester: John Wiley, 1995: 323334. Google ScholarPubMed
ÜStün, TB, Sartorius, N. Mental Illness in General Health Care. Chichester: John Wiley, 1995. Google Scholar
Härter, M, Reuter, K, Gross-Hardt, K, Bengel, J. Screening for anxiety, depressive and somatoform disorders in rehabilitation – validity of HADS and GHQ-12 in patients with musculoskeletal disease. Disabil Rehabil 2001;23: 737744.Google ScholarPubMed
Reuter, K, Härter, M. Screening for mental disorders in cancer patients – discriminant validity of HADS and GHQ-12 assessed by standardized clinical interview. Int J Meth Psychiatr Res 2001;10: 8696. CrossRefGoogle Scholar
Rief, W, Hessel, A, Braehler, E. Somatization symptoms and hypochondriacal features in the general population. Psychosom Med 2001;63: 595602.CrossRefGoogle ScholarPubMed
Robert-Koch-Institute. Public Use File Bundes-Gesundheitssurvey 1998 – Kernsurvey [Public Use File GHS-CS98]. Berlin: Robert Koch-Institute, 2000. Google Scholar
Max-Planck-Institute. Public Use File Bundes-Gesundheitssurvey 1998 – Zusatzsurvey “Psychische Störungen”[Public Use File GHS-MHS98]. Munich: Max-Planck-Institute of Psychiatry, 2000. Google Scholar