Characteristics of oligosymptomatic versus polysymptomatic presentations of somatoform disorders in patients with suspected allergies

Hausteiner, Constanze; Huber, Dorothea; Bornschein, Susanne; Grosber, Martine; Bubel, Esther; Groben, Sylvie; Lahmann, Claas; Löwe, Bernd; Eyer, Florian; Eberlein, Bernadette; Ring, Johannes; Behrendt, Heidrun; Darsow, Ulf; Henningsen, Peter

doi:10.1016/j.jpsychores.2010.03.006

« Previous Next »Journal of Psychosomatic Research
Volume 69, Issue 3 , Pages 259-266, September 2010

Characteristics of oligosymptomatic versus polysymptomatic presentations of somatoform disorders in patients with suspected allergies

Department of Psychosomatic Medicine and Psychotherapy, Technische Universitaet Muenchen (TUM), Munich, Germany

Department of Psychiatry and Psychotherapy, TUM, Munich, Germany

Department of Dermatology and Allergology, TUM, Munich, Germany

Division of Environmental Dermatology and Allergology, Helmholtz Center Munich for Environmental Health/TUM, Munich, Germany

Department of Psychosomatic Medicine, University Medical Center Hamburg-Eppendorf and Schoen-Klinik Hamburg-Eilbek, Hamburg, Germany

Clinical Toxicology, Department of Internal Medicine, TUM, Munich, Germany

ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Department of Dermatology and Allergy, TUM, Munich, Germany

Department of Psychosomatic Medicine and Psychotherapy, Klinikum Harlaching, Munich, Germany

Received 10 July 2009; received in revised form 9 March 2010; accepted 9 March 2010. published online 20 April 2010.

Abstract

Objective

Psychobehavioral characteristics of patients with somatoform disorders (SFDs), are increasingly discussed as possible positive criteria for this diagnostic group. However, little is known about psychobehavioral differences, or similarities, between the different SFD presentations, i.e., polysymptomatic [multisomatoform/somatization disorders (MSD)] versus mono- or oligosymptomatic courses [pain disorder (PD), undifferentiated somatoform disorder (USD)].

Methods

This is a cross-sectional study including 268 consecutive allergology inpatients. After an Structured Clinical Interview for DSM-IV, patients completed several self-rating questionnaires. Results were compared within the different SFD presentations as well as between patients with versus without SFDs.

Results

We identified 72 patients with an SFD. There were fewer and smaller psychobehavioral differences within patients with the different SFD presentations (MSD, USDs, PDs) than between patients with undifferentiated versus no SFD. Patients with one of the three different SFD subdiagnoses scored similarly on many measures referring to psychosocial distress (e.g., psychological distress, mental health-related quality of life, dissatisfaction with care). The number of reported symptoms, somatic symptom severity, a self-concept of bodily weakness, the degree of disease conviction, and physical health-related quality of life discriminated the different SFD presentations not only from patients without SFDs but also from each other.

Conclusions

Patients diagnosed with one of the different SFD subtypes share many psychobehavioral characteristics, mostly regarding the reporting of psychosocial distress. Perceived somatic symptom severity and physical impairment as indicators of bodily distress could either further define categorical subdivisions of SFD or dimensionally graduate one general SFD category defined by bothering bodily symptoms and disproportionate psychosocial distress.

Keywords: Classification, Dimensional assessment, Distress, Positive criteria, Psychobehavioral characteristics, Somatoform disorders