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Introduction While previous literatures have provided substantial evidence on the burden of somatic symptoms and the prognostic value of resilience in the treatment course of depression, little is speculated on the relationship between resilience and somatic symptoms in depressed patients. We aimed to clarify the relationship between resilience and somatic symptoms in depressed patients retrospectively. Methods Two hundred and fifty-four outpatients with depressive disorders participated in the study and completed self-administered questionnaires regarding demographic, clinical and psychological factors. We divided the patients into four groups based on their scores of Connor- Davidson Resilience Scale and Beck Depression Inventory. The partial correlation analysis was implemented to show the relationship between somatic symptoms and resilience after controlling for depression, and one-way analysis of variance was conducted to demonstrate the differences in somatization scores of Symptoms Checklist-90- Revised in the aforementioned four groups. Results After the correlation analysis, somatization was significantly correlated with resilience even after controlling for depressive symptoms. The one-way analysis of vairance and post-hoc analysis revealed statistically significant differences in somatization scores between the four groups, with the high Beck Depression Inventory, high Connor- Davidson Resilience Scale group having the highest somatization scores. Discussion Striving to be resilient during the peak of depression, cultural factors and positive illusions of depressed patients can result in high resilience scores and high somatization scores in depressed patients, and such clinical implications would help clinicians evaluate resilience and somatization in depressed patients with multidimensional aspects. [ABSTRACT FROM AUTHOR]

Somatization disorder (SD) was included as a new syndrome in the DSM-III (APA, 1980), but its removal from the DSM-V as a diagnostic category is more than probable. This work examines the main studies that SD has generated in the last 30 years as regards epidemiology, comorbidity, and associated psychological variables: illness concern, somatosensory amplification, somatic attribution, alexithymia, and neuroticism. The several nosological proposals in the past decade are also revised, as well as the debate that developed until the current DSM-V classification proposals. The radical changes proposed by the DSM-V work group are considered necessary and positive, although two risks of the proposal are also exposed: clustering under the same diagnostic category the current SD and hypochondriasis, and including non-explained and factitious symptoms in the same category. [ABSTRACT FROM AUTHOR]

Somatization is a clinical and public health problem as it can lead to social dysfunction, occupational difficulties and increased healthcare use. Hence understanding somatoform disorders is of paramount importance, especially so in developing countries like India. This paper discusses the history and evolution of the concept of somatization and somatoform disorders, etiological considerations, classification, assessment, diagnosis and clinical management. Research from India, controversies and criticisms and future perspectives are mentioned. A new model to understand functional somatic symptoms, in Indian setting is also proposed. [ABSTRACT FROM AUTHOR]

Background: Somatoform disorders are an important factor in functional disability and role impairment, though their independent contribution to disability has been unclear because of prevalent medical and psychiatric comorbidity.Objectives: To assess the extent of the overlap of somatization with other psychiatric disorders and medical problems, to compare the functional disability and role impairment of somatizing and non-somatizing patients, and to determine the independent contribution of somatization to functional disability and role impairment.Design: Patients were surveyed with self-report questionnaires assessing somatization, psychiatric disorder, and role impairment. Medical morbidity was indexed with a computerized medical record audit.Participants: Consecutive adults making scheduled visits to their primary care physicians at two hospital-affiliated primary care practices on randomly chosen days.Measurements: Intermediate activities of daily living, social activities, and occupational disability.Results: Patients with somatization, as well as those with serious medical and psychiatric illnesses, had significantly more impairment of activities of daily life and social activities. When these predictors were considered simultaneously in a multivariable regression, the association with somatization remained highly significant and was comparable to or greater than many major medical conditions.Conclusions: Patients with somatization had substantially greater functional disability and role impairment than non-somatizing patients. The degree of disability was equal to or greater than that associated with many major, chronic medical disorders. Adjusting the results for psychiatric and medical co-morbidity had little effect on these findings. [ABSTRACT FROM AUTHOR]

This paper is a critique of the cross-cultural utility and validity of somatization in the diagnosis and treatment of psychological disorders. Somatization is defined as the process by which psychological distress is expressed as physical symptoms that have no known organic basis. Rather than a phenomenon limited to non-western cultures as commonly thought of in the past, somatization should be recognized as a universal experience found across cultures. It underscores the significant interrelationships between the mind/psyche and the body, an area embraced by some disciplines such as Jungian psychology and psychotherapy, but historically neglected by bioscience. This paper argues that the reputedly low prevalence of somatization observed in western cultures is an artifact, due to the overly restrictive diagnostic criteria used in clinical practice. This paper argues in favor of the retention of somatization as a valid concept in diagnosis, treatment, and in psychotherapy, especially at a time of increasing cultural diversity. [ABSTRACT FROM AUTHOR]

Objective: High suggestibility is widely regarded as an important feature of patients with medically unexplained symptoms (MUS), particularly those with multiple MUS [i.e. somatization disorder (SD)], although there are few empirical data attesting to this assumption. A study was therefore conducted to compare levels of non-hypnotic suggestibility in patients with SD and medical controls. Method: A modified version of the Barber Suggestibility Scale was administered to 19 patients with SD and 17 controls with an established organic dystonia. Results: Patients with SD were no more suggestible than control patients. Dystonia controls were more likely to deliberately comply with suggestions than the SD patients. Conclusion: Contrary to popular belief, high suggestibility is not necessarily a feature of SD. [ABSTRACT FROM AUTHOR]

This study sought to identify child and parent characteristics differentiating children with recurrent abdominal pain seen by a pediatrician (RAP-Peds) from those seen by a gastroenterologist (RAP-GI). Children (7—10 years) and mothers in three groups (RAP-GI, RAP-Peds, and Controls) completed mother and child reports of child's functional disability, internalizing symptoms, and somatic complaints, and mother report of her anxiety and somatization. Child report did not differentiate groups. RAP mothers were more likely than Control mothers to focus on somatic complaints in themselves and their children. Mother report of child disability was strongly related to tertiary care for child's recurrent abdominal pain. [ABSTRACT FROM AUTHOR]

Much research has recently been conducted on somatoform disorders demonstrating their clinical importance, associated health-service burden and economic cost. These conditions are often comorbid with other mental and physical disorders and particularly prevalent in primary care and general medical settings. Although culture-specific manifestations and variations of somatization occur—it is now accepted that medically unexplained somatic symptoms are a universal phenomenon. The management of somatoform disorders is generally a complex and lengthy process; however, a number of recent studies have demonstrated the effectiveness of short-term treatments such as cognitive behaviour therapy and educational interventions. Despite advances in their understanding and treatment, debate still surrounds the conceptualization and categorization of somatoform disorders, with a number of experts proposing a complete revaluation and reassignment of this diagnostic classification category. The following paper represents a review of recently published literature on frequency, characteristics, conceptualization, impact and management of somatoform disorders. [ABSTRACT FROM AUTHOR]

Somatic symptoms can occur in disease-free cancer patients. The causes of such symptoms in cancer can be many and varied. These could be due to anxiety, depression, somatization or a manifestation of illness behaviour. Somatic symptoms can also arise out of treatments for the cancer like radiation treatment or chemotherapy. Cancer related somatic symptoms have cognitive, psychological, and physiological causes, each of which is amenable to treatment. The occurrence of somatoform disorders in cancer patients is likely to complicate the treatment and outcome of the cancer. Common somatic symptoms in cancer have been found to be pain, fatigue, anorexia, tiredness or exhaustion, weakness, reduced energy, lethargy, and tremors. Breathlessness, muscle pain, dizziness, and palpitation are common symptoms of anxiety and panic attack which have also been noted in cancer patients. Somatic concern and preoccupation are also common. These symptoms create difficulty in diagnosing depression and anxiety in cancer patients, and leads to the need for modification of the standard diagnostic criteria. Somatic symptoms in cancer respond to counselling and psychopharmacotherapy. More research are needed on this area to understand the process of somatization in a somatic disease. [ABSTRACT FROM AUTHOR]

Background Among older people, somatization has been reported to be common and to be predictive of high attendance in primary care. Its relationship with quality of life among older people has not been investigated. Objectives The objective was to establish whether, among older primary care attenders, somatized symptoms are independently associated with relevant measures of quality of life. Method Older primary care attenders (n = 127) completed measures of somatized symptoms, psychiatric status, physical health and health-related quality of life. Logistic regression analyses established independent relationships of health and sociodemographic variables with reports of overall quality of life, overall health, restriction of physical activities by health and restriction of social activities by health. Results For all four outcomes, somatized symptoms independently predicted poorer quality of life ratings. Conclusions Somatized symptoms independently influence quality of life in older primary care patients and are worthy of clinical attention. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: The narrow ICD-10 and DSM- IV definition of hypochondriasis makes it rarely used yet does not prevent extensive diagnosis overlap. This study identified a distinct hypochondriasis symptom cluster and defined diagnostic criteria. Method: Consecutive patients (N=1 ,785) consulting primary care physicians for new illness were screened for somatization, anxiety, depression, and alcohol abuse. A stratified subgroup of 701 patients were interviewed with the Schedules for Clinical Assessment in Neuropsychiatry and questions addressing common hypochondriasis symptoms. Symptom patterns were analyzed by latent class analysis. Results: Patients fell into three classes based on six symptoms: preoccupation with the idea of harboring an illness or with bodily function, rumination about illness, suggestibility, unrealistic fear of infection, fascination with medical information, and fear of prescribed medication. All symptoms, particularly rumination, were frequent in one of the classes. Classification allowed definition of new diagnostic criteria for hypochondriasis and division of the cases into "mild" and "severe." The weighted prevalence of severe cases was 9.5% versus 5.8% for DSM-IV hypochondriasis, Compared with DSM-IV hypochondriasis, this approach produced less overlap with other somatoform disorders, similar overlap with nonsomatoform psychiatric disorders, and similar assessments by primary care physicians. Severe cases of the new hypochoridriasis lasted 2 or more years in 54.3% of the subjects and 1 month or less in 27,2%. Conclusions: These results suggest that rumination about illness plus at least one of five other symptoms form a distinct diagnostic entity performing better than the current DSM-IV hypochondriasis diagnosis. However, these criteria are preliminary, awaiting cross-validation in other subject groups. [ABSTRACT FROM AUTHOR]

Focuses on several issues in somatoform disorders. Definition of somatoform disorders; Categories of the disorders; Prevalence of somatoform disorders.

Background. There is little research that examines demographic, clinical and treatment factors associated with changes in physical symptoms, psychiatric symptoms and functional outcome in patients with somatized depression or anxiety in primary care. Method. Factors associated with the outcome of psychologized or somatized depression or anxiety were derived from the literature. These factors were tested individually for their effects on changes in physical symptoms, psychiatric symptoms and functional outcome between baseline consultation with the general practitioner and 1 or 3 months later in 215 patients with somatized depression or anxiety. Individual factors associated with a particular outcome, demographic, DSM-IV diagnosis and treatment variables were entered into a multiple regression analysis. Results. Factors associated with a better outcome on all three types of outcome measure were the absence of generalized anxiety disorder and/or simple or social phobias, absence of physical pathology, and the prescription of fewer drugs, especially hypnotics or benzodiazepines. In addition, a better psychiatric symptom outcome was associated with the patients' perceived satisfaction with the general practitioner's understanding or explanation of the patient's problems. A better functional outcome was associated with having a job, less distress over physical symptoms, not receiving invalidity benefit and no referral to hospital. Conclusion. There are clinical and demographic factors associated with all types of short-term outcome in patients with somatized depression or anxiety but there are additional factors that are associated only with either psychiatric or functional outcome. [ABSTRACT FROM AUTHOR]

A self-report questionnaire completed by 177 out-patients showed that hypochondriasis and amplification had a zero-order correlation of 0.56, and in stepwise multiple regression amplification accounted for 31% of the variance in hypochondriasis, after sociodemographic variables had been accounted for. Fears of ageing and death, and a childhood history of illness in the family, increased the R2 to 0.50. Amplification was more powerful in women than in men and was also a significant (although weaker) correlate of somatisation, explaining 12% of the variance. Somatisation also correlated with being female, the propensity to seek medical care, and a diminished sense of efficacy over one's health. Our findings are consistent with the possibility that somatosensory amplification occurs in hypochondriasis. [ABSTRACT FROM AUTHOR]

The study began with the systematic clinical evaluation of a cross-section of 500 of the clinic's patients. This was followed by a 'blind' follow-up of the index subjects and a 'blind' study of first-degree relatives. The present report deals with the diagnosis of Briquet's syndrome (hysteria, somatisation disorder) at index, at follow-up, and among first-degree relatives. The data indicate that the criteria used for the diagnosis of Briquet's syndrome select patients who show a high degree of diagnostic consistency over many years, although not all patients who meet these criteria at follow-up receive the diagnosis of Briquet's syndrome initially. Most importantly, the diagnostic criteria select cases associated with a strong familial increase in the risk of Briquet's syndrome and in the risk of antisocial personality. Both are increased among first-degree female relatives, while only antisocial personality is increased among first-degree male relatives. [ABSTRACT FROM AUTHOR]

The article presents several studies on the role of psychiatric disorder in parental breakdown. These studies have significance in establishing a role for psychiatric disorder. The authors of these studies selected 50 patients who had Briquet's syndrome and other criteria for somatization disorder. With this, the researchers found that poor parenting had been associated with a specific psychiatric disorder as measured by child abuse or the removal of the child from the home. Furthermore, these studies consider severe parenting problems and some have noted women with depression alone to have parental difficulties.

The DSM-III-(R) definition of somatization disorder is too restrictive for use in general practice. A more comprehensive definition, the "somatic symptom index" (SSI) has shown good validity in open populations. However, a definition has to differentiate validly within a population of frequent attenders to be a useful diagnostic instrument in general practice. We studied a threshold of five complaints (nearly identical to the SSI) in 80 Dutch general practice patients. Patients were selected on age (20-44 years), history of back, neck or abdominal complaints, and on frequency of consultation- at least 12 consultations in the previous 3 years, corrected for consultations with compelling somatic reason for encounter. Prevalence of somatization in this group was 45%. Women had a 2 times higher risk of somatization. A relation with age was not found. Somatization was related to depressive complaints (relative risk 2.5) and probably also to anxiety. Somatizing patients consulted their general practitioner more often and had more health problems (especially psychic problems) than non-somatizers. These results support the validity of this definition. The distinction between our definition of somatization and somatization defined as a symptom of psychiatric (e.g. depressive or anxiety) disorder is emphasized. [ABSTRACT FROM AUTHOR]

The article presents a study that describes the clinical features of patients with depressive disorders who were referred to a special hypochondriasis clinic after prolonged general medical evaluation. The study compared 21 patients with similar diagnosis but no somatic symptoms and patients with depressive illnesses developing somatic symptoms. The study found that patients with somatic symptoms have greater similarity between their pattern of symptoms and those of their mothers, poorer marriage relationships and sexual adjustment and a greater chronicity of the current illness compared to patients without somatic symptoms.

We describe the patterns of illness attributed to sorcery among 209 patients who attended a special clinic in south India. Somatisation and conversion disorders accounted for the majority of patients, although several other psychiatric and medical disorders were also seen. Aspects of treatment of such patients in the sociocultural context are discussed. [ABSTRACT FROM AUTHOR]