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Somatization disorders in non psychiatric settings: A multidimensional diagnostic approach

Published online by Cambridge University Press:  18 September 2015

H. Ebel  and
M. Müller-Küppers
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Summary

Given the diagnostic ambiguity of physically unexplained complaints we wanted to study whether the clinically and symptomatically characterized groups, all of them defined according to DSM-III-R criteria, could be reclassified using selected empirical and theoretical variables of operationally defined parameters.

Patients with conversion (N = 75), somatization or undifferentiated somatoform disorders (N = 74) and major depression (N = 70) according to DSM-III-R underwent multidimensional work-up including psychopathological, personality-psychological, illness, behavioral and coping assessment. The clinically characterized groups should be statistically reclassified by discriminant analytic techniques.

The existing diagnostic categories according to DSM-III-R could be widely confirmed by the statistical reconstitution of the clinical groups. Conversion, somatization and depressive disorder presented as distinct clinical categories.

A classification relying widely on symptoms still seems to be too superficial and does not represent the complexity of these patients. Thus, the modern classification systems with their purely phenomenological criteria should be added with further dimensions.

Keywords

conversion disorderhypochondriasismood disordersomatization disorder
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 11 , Issue 4 , December 1999 , pp. 117 - 119
Copyright
Copyright © Cambridge University Press 1999

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References

Literature

1.Schepank, H. Psychogene Erkrankungen der Stadtbevölkerung. Eine epidemiologisch tiefenpsychologische Feldstudie in Mannheim. Berlin, Springer, 1987.CrossRefGoogle Scholar
2.Purteil, JJ, Robins, E, Cohen, ME. Observations on clinical aspects of hysteria. A quantitative study of 50 hysteria patients and 156 control subjects. JAMA 1951; 46: 901–9.Google Scholar
3.Ford, CV, Folks, DG. Conversion disorders: an overview. Psycho-somatics 1985; 26: 371–83.CrossRefGoogle ScholarPubMed
4.Cohen, IH. Masked depression in the medical patient. Modern Treatment 1969; 6: 688–94.Google ScholarPubMed
5.Lopez Ibor, JJ. Masked depressions. Br J Psychiatry 1972; 120: 245–58.CrossRefGoogle ScholarPubMed
6.Kielholz, P. Masked depression. Bern, Huber, 1973.Google Scholar
7.Lesse, S. Masked depression and depressive equivalents. In: Arierti, S (ed). American Handbook of Psychiatry, 2nd Ed, Vol. VII. New York, Basic Books, 1974, pp 318–29.Google Scholar
8.Fisch, RZ. Masked depression: its interrelations with somatization, hypochondriasis and conversion. Int J Psychiatry Med 1987; 17: 367–79.CrossRefGoogle ScholarPubMed
9.Kaplan, C, Lipkin, M, Gordon, GH. Somatization in primary care: patients with unexplained and vexing medical complaints. J Gen Intern Med 1988; 3: 101–6.CrossRefGoogle ScholarPubMed
10.Derogatis, LR. SCL-90-R, administration, scoring & procedure manual-I for the R(evised) version. Eigendruck, John Hopkins University School of Medicine.Google Scholar
11.Beck, AT, Warsch, CH, Medelson, M, Mock, F, Erbaugh, F. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561–71.CrossRefGoogle ScholarPubMed
12.Spielberger, CD, Gorsuch, RL, Lushene, RE. Manual for the State-Trait-Anxiety Inventory. Palo Alto, Consulting Psychologists Press, 1970.Google Scholar
13.Endicott, J, Spitzer, RL, Fleiss, J. The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbances. Arch Gen Psychiatry 1976; 33: 766–71.CrossRefGoogle Scholar
14.National Institute of Mental Health 012 CGI. Clinical Global Impressions. In: Guy, W, Bonato, RR (eds). Manual for the ECDEN Assessemnt Battery, 2. Rev. Maryland, Chevy Chase, 1970.Google Scholar
15.Fahrenberg, J, Hampel, R, Selg, H. Das Freiburger Persönlichkeitsinventar, 4. revidierte Auflage. Gottinge, Hogrefe, 1984.Google Scholar
16.Watson, D, Clark, LA, Tellegen, A. Development and validation of brief measures of positive and negative affect: the PANAS Scales. J Pers Soc Psychol 1988; 54: 1063–70.CrossRefGoogle ScholarPubMed
17.Taylor, GJ, Ryan, DP, Bagby, RM. Towards the development of a new self-report alexithymia scale. Psychother Psychosom 1985; 44: 191–9.CrossRefGoogle Scholar
18.Barsky, AJ, Wyshak, GL. Hypochondriasis and somatosensory amplification. Br J Psychiatry 1990; 157: 404–9.CrossRefGoogle ScholarPubMed
19.Pilowsky, I, Spence, ND. Manual for the Illness Behavior Ques-tionaire (IBQ) Second Edition. Adelaide, Author, 1983.Google Scholar
20.Pilowsky, I. Dimensions of hypochondriasis. Br J Psychiatry 1967; 113: 89–93.CrossRefGoogle ScholarPubMed
21.Kellner, R. The prognosis of treated hypochondriasis: a clinical study. Acta Psychiatr Scand 1983; 67: 69–79.CrossRefGoogle ScholarPubMed
22.Lachenbruch, PA. An almost unbiased method of obtaining confidence intervals for the probability of misclassification in discriminant analysis. Biometrics 1967; 23: 639–45.CrossRefGoogle ScholarPubMed