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PubMedDate not supplied

Alterations of benzodiazepine receptor binding potential in anxiety and somatoform disorders measured by 123I-iomazenil SPECT.

123I-iomazenil (IMZ), a newly developed radioligand which acts on benzodiazepine receptors (BZR) as a partial inverse agonist, made it possible to evaluate the function of central BZR by single photon emission tomography (SPECT). To examine the alterations of the binding potential (BP) in the anxiety state, 123I-IMZ SPECT was performed in five patients with anxiety and somatoform disorders, and five epileptic patients without anxiety symptoms served as a reference. The BP of BZR was determined by using a table look-up procedure based on a three-compartment, two-parameter model in the bilateral superior frontal, inferior frontal, temporal, parietal, occipital, and cerebellar cortex. The mean BP of patients with anxiety and somatoform disorders was significantly decreased in the superior frontal, temporal, and parietal cortex, in comparison with that of epileptic patients. A significant correlation was observed between the anxiety levels scored on the Hamilton anxiety scale and BP in the right temporal cortex and left superior frontal cortex. These changes in BZR revealed by SPECT suggest the usefulness of 123I-IMZ SPECT to objectively evaluate anxiety levels in patients with anxiety symptoms.

Adult↗

PubMedDate not supplied

Somatoform disorders and DSM-V: conceptual and political issues in the debate.

This article furthers the debate on the future of somatoform disorders by critically reviewing the relevant terminology and validity for the separate grouping and classification of these disorders. It is suggested that political pressures to change certain terms should be resisted, and that such changes should be made only if the alternatives have clear advantages.

Attitude↗

PubMed1994

The Effect of Somatoform Disorder and Paranoid Psychotic Role-Related Dissimulations as a Response Set on the MMPI-2

Two hundred thirty-seven undergraduate students were assigned to three instructional groups: somatoform disorder, paranoid psychotic, and general "fake-bad," and a standard test-retest control group in order to investigate the impact of specifically defined, role-related dissimulations on responding to the MMPI-2. It was found that each instructional group differed from the control group on a majority of MMPI-2 clinical and validity scales. Although the group that simulated the somatoform disorder differed from the simulated paranoid psychotic and general fake-bad groups, the simulated paranoid psychotic and general fake-bad groups did not differ from each other. An examination of various cutting scores suggests that validity indices used with the MMPI (i.e., F, F-K) are also useful with the MMPI-2. Overall, the F scale seems to be the most effective validity index. Implications for future MMPI-2 and malingering research are discussed.

Journal Article↗

PubMed2006

Syndrome stability and psychological predictors of symptom severity in idiopathic environmental intolerance and somatoform disorders.

BACKGROUND: Previous studies suggest that idiopathic environmental intolerance (IEI) is a variant of somatoform disorders (SFDs) or the so-called functional somatic syndromes. Little is known, however, about the stability and the psychological predictors of IEI. METHOD: This prospective study examined the 1-year stability of somatic symptoms and IEI features in three diagnostic groups: 49 subjects with IEI, 43 subjects with SFD but without IEI, and 54 subjects (control group, CG) with neither IEI nor SFD. The predictive value of typical psychological predictors for somatization was tested using zero-order correlations and multiple linear regression analyses. RESULTS: Somatic symptoms and IEI features proved to be temporally stable over the 1-year follow-up period. The SFD and IEI groups scored significantly higher than CG on all measures of somatic symptoms and on questionnaires assessing psychological predictors for somatization. Measures of trait negative affectivity (NA), somatic symptom attribution and somatosensory amplification predicted somatic symptom severity within the IEI and SFD groups, both at baseline and 1 year later. The strongest predictors of IEI complaints in the IEI group were somatic attributions, followed by prominent cognitions of environmental threat and a tendency to focus on unpleasant bodily sensations and to consider them as pathological. CONCLUSIONS: IEI and SFD are highly stable conditions. In both SFD and IEI, NA and the processes of symptom perception, interpretation and attribution contribute substantially to the persistence of typically somatoform symptoms and IEI complaints. Treatment of IEI and SFD should address these psychological factors and mechanisms.

Adult↗

PubMedDate not supplied

Somatoform disorders in consultation-liaison psychiatry: a comparison with other mental disorders.

Consultation-liaison (C-L) psychiatry has an important role in the management of somatoform disorders (SD). Characteristics of SD patients in C-L psychiatry are largely unknown and are presented in this paper. We analyzed 13,314 Dutch psychiatric consultations from 1984 to 1991 and compared patients diagnosed with SD to patients with other mental disorders and to those without a mental disorder. The comparison included socio-demographic variables, consult characteristics, medical history, current somatic morbidity, information about additional diagnostic tests, hospital admission time and aftercare management. Of the 544 SD patients 39.5% (n = 215) were diagnosed with a conversion disorder that illustrates the highly selected nature of SD patients in C-L psychiatry. Employment among SD patients decreased significantly from 58% in the group aged 20-29 years to 6% in the group aged 50-59 years. This decrease was significantly larger as compared to other mental disorders and no mental disorders and was virtually unaffected by correction for potential confounding by gender. Contrary to our expectation no difference between the three groups was observed in claims for disability benefits. Of the SD patients 74.5% were referred for aftercare management, significantly more than the other two groups which is considered a promising development in C-L psychiatry.

Adolescent↗

PubMed1999

[Organic somatoform disorder. Case report].

Based on the neuropsychological and imagenological evaluation of a frontal damaged patient with a somatoform disorder, we study the differential diagnosis of this condition compared to that of other patients: temporal or parietal damaged ones, schizophrenics, melancholics, obsessives, hypochondriacs and dismorphophobics.

Adolescent↗

PubMed1994

Somatoform disorders--diagnostic concept, controlled clinical trials, and methodological issues.

The paper summarizes the concept of somatoform disorders, which was first introduced in the Diagnostic and Statistical Manual of Mental Disorders in its third edition in 1980. The relevant clinical trials related to this concept are reviewed. On the basis of this experience, the present study discusses methodological requirements for clinical trials, including inclusion and exclusion criteria, measurements of efficacy and safety, and statistical considerations, in the hope that this will stimulate the use of this diagnostic entity in the future.

Clinical Trials as Topic↗

PubMedDate not supplied

Prevalence of somatoform disorders in a large sample of patients with anxiety disorders.

The authors investigated the prevalence and characteristics of somatoform (SOM) disorders among 654 subjects with anxiety disorders who were part of the larger Harvard/Brown Anxiety Disorders Research Project. Thirty-six (5.5%) of the subjects had past or current SOM disorders. The subjects with SOM disorders were significantly more likely to have histories of posttraumatic stress disorder (22% vs. 8%, P = 0.01). The subjects with generalized anxiety disorder had significantly higher rates of SOM disorder (9.2% vs. 4.0%, P = 0.01). These results add support to the observation that SOM disorders are frequently comorbid with anxiety and depressive disorders.

Anxiety Disorders↗

PubMedDate not supplied

[Decrease in the platelet level of 43 kDa immunoreactive fraction of serotonin transporting protein correlates with depressive symptoms in patients with somatoform disorders].

To elucidate the role of serotonin transporter (SERT) protein as a candidate target for somatoform disorders (SD), we have performed an association study of the SERT immunoreactive (IR-SERT) protein level by using site-specific antibodies directed at C-terminus epitope poorly conserved among other cotransporters. 22 patients who met DSM-IY criteria for SD and 32 healthy volunteers matched in sex and age participated in the study. In platelets from all healthy donors, IR-SERT proteins migrates as a diffuse band between 75 and 102 kDa and a major sharper band at 43 kDa. We revealed almost complete disappearance of platelet 43 kDa IR-SERT protein in all patients with SD. All patients were rated with Hamilton Depressive Rating Scale (HDRS). There were found a significant negative correlation between residual IR-SERT 43 kDa protein level and HDRS Scores [r = -0.83; P < 0.000001]. These findings suggest that a biosynthetic or processing abnormality may exist in SERTs in the affected population and may reflect the dysfunction of serotonin neurotransmission in CNS.

Adult↗

PubMed2006

Associations between physical and psychological problems in a group of patients with stress-related behavior and somatoform disorders.

The research questions in this study were. How do patients with stress-related behavior and somatoform disorders assess symptoms and self-image compared to healthy individuals, and how are these assessments related to bodily resources, assessed with a physiotherapeutic body examination? The test group (n = 31) consisted of consecutive patients referred to a treatment center specializing in psychosomatic problems. Significant differences (p < or = 0.01) were found between the test and comparison group (n = 22) on all but two of the ten subscales of the Resource-Oriented Body Examination (ROBE II). This was also the case for all the subscales of The Symptom Checklist-90(SCL-90; comparison group n = 52), and for all but three of the eight clusters of the Structural Analysis of Social Behavior (SASB) (comparison group n = 52). For the patient group, the ROBE II subscale Increased respiratory control correlated significantly with the SCL-90 subscales that measures Anger-hostility, Phobic anxiety, Paranoid ideation, with the Personality Severity Index (PSI) and with the SASB clusters Daydreaming and self-neglect, Self-indictment and oppression with r's between 0.38 and 0.50. Body examination with ROBE II might provide a useful assessment tool in patients whose stress-related problems appear to contain associations between psychological and physical problems.

Anxiety Disorders↗

PubMed2005

Psychobiological perspectives on somatoform disorders.

Common physical symptoms such as abdominal pain, headache, back pain and dizziness play a major role for the health care system. Existing models for the development and maintenance of these symptoms emphasize a vicious circle with cognitive-perceptual, behavioral, and psychobiological components. In this manuscript, we present examples of psychobiological factors that might contribute to somatoform disorders. We emphasize that somatoform symptoms are not strictly mental events, but are associated with a diversity of biological processes. The possible role of the endocrine and immune system, amino acids and neurotransmitters, but also physiological activation and cerebral activity is exemplified. These approaches are categorized using a model of perception and filtering of bodily signals. Studies are needed that combine the investigation of different biological systems with assessments of psychological variables in longitudinal trials, but also experimental investigations in humans examining the interaction of behavior changes, biological variations, and body perception are still rare.

Animals↗

PubMed2001

[A combination of cognitive and psychodynamic components in the psychotherapy of somatoform disorders].

Psychological research has identified difficulties in the awareness, verbalization and recognition of emotions in patients with somatoform disorders. Problems in the recognition of emotions are usually labeled as alexithymia. Patients with alexithymic characteristics need a special psychotherapeutic approach, which may be described as follows: The first stage of treatment aims to overcome the alexithymic barrier along with the development of self-monitoring skills for emotional states. A favorable setting for this work is group psychotherapy. In this stage of treatment cognitive targets and interventions dominate. These include: 1. the link between emotions and physiological response; teaching the fundamental laws of emotional life and the importance of emotional hygiene. 2. Improving awareness of difficulties in the recognition and expression of emotions. 3. Changing the patients negative attitude towards emotions. The second stage of the group work is mainly oriented towards the cognitive analysis of dysfunctional basic beliefs. In this stage psychodynamic issues become more important which include resistance and transference reactions, feedback of group members, analysis of social and familial contexts and the working through of traumatic childhood experiences.

Cognitive Behavioral Therapy↗

PubMedDate not supplied

Psychiatric syndromes in Persian Gulf War veterans: an association of handling dead bodies with somatoform disorders.

BACKGROUND: Traumatic combat experience has been associated with the development of posttraumatic stress disorder, but there have been few studies about the association of military combat experience and the development of somatoform disorders. METHODS: The authors evaluated 131 referred Gulf War veterans for medical and psychiatric syndromes thought related to their involvement in the Gulf War. Patients completed questionnaires regarding their traumatic experiences and were interviewed using the Structured Clinical Interview for DSM III-R. RESULTS: For the sample, 69% had axis I conditions. Major depression, undifferentiated somatoform and posttraumatic stress disorders were the most common diagnoses. Reports of traumatic events were associated with both posttraumatic stress disorder (p < 0.05) and somatoform diagnoses (p < 0.05). Veterans who handled dead bodies had a 3-fold risk of receiving a somatoform diagnosis (p < 0.05). CONCLUSIONS: Psychiatric syndromes may explain some medical complaints following involvement in the Persian Gulf War. The results suggest that some psychological and nonspecific somatic symptoms persisting since the Gulf War may be related to exposure to psychological trauma.

Adult↗

PubMed2006

[Paranoia and symptoms of somatoform disorders in a Nigerian refugee. A case study].

A female Nigerian refugee presented with a combination of paranoia and symptoms of somatoform disorders. Her symptoms were interpreted as a cultural expression of postpartum depression. The psychotic symptoms subsided when the patient was admitted to a psychiatric crisis unit and was given antipsychotics. We describe a model that can be used to treat remaining somatoform symptoms with patient-generated metaphors.

Adult↗

PubMedDate not supplied