Lifetime diagnoses in patients with somatoform disorders: Which came first?
- 111 Downloads
Thirty inpatients with somatoform disorders were examined with the structured clinical interview SCID for psychiatric lifetime diagnosis. In the present diagnoses, we found a concordance of 63% for somatoform and affective disorders and the lifetime comorbidity of both disorders was 87%. Additionally, patients with somatoform disorders frequently had a history of other psychiatric disorders (for example, anxiety disorders, 40%). For 73% of patients with somatoform disorders and a history of affective disorders, the onset of the somatoform disorder was prior to the onset of another psychiatric disorder. The time interval between the onsets of somatoform disorders and affective disorders was greater than 1 year for most patients; for 46% of the patients with a history of both disorders, the time interval between the two disorders was more than 5 years. The course of illness for somatoform and affective disorders was quite different; while affective disorders tended to episodic periods with interim remissions, the somatoform disorders usually showed long, chronic courses (mean duration of the current somatoform disorder was 11.9 years). Finally, the Symptom Check List SCL-90R demonstrated good discrimination between patients with affective and anxiety disorders. However, the SCL-90R failed to discriminate patients with somatoform disorders from affective- and anxiety-disordered subjects. Therefore, the development of other psychometric scales is necessary for the evaluation of patients with somatoform disorders.
Key wordsSomatoform disorders Somatization disorder DSM-III-R Lifetime diagnoses Affective disorders Anxiety disorders SCL-90R
Unable to display preview. Download preview PDF.
- American Psychiatric Association (1980) Diagnostic and statistical manual for mental disorders, 3rd edn. American Psychiatric Association, Washington, DCGoogle Scholar
- American Psychiatric Association (1987) Diagnostic and statistical manual for mental disorders, 3rd edn (revised). American Psychiatric Association, Washington, DCGoogle Scholar
- Brown GW and Harris TO (1982) Social origins of depression. Tavistock Publications, LondonGoogle Scholar
- CIPS (1986) Internationale Skalen für Psychiatrie [International Scales for Psychiatry]. Beltz, WeinheimGoogle Scholar
- Escobar JI, Rubio-Stipec M, Canino G and Karno M (1989) Somatic Symptom Index: a new and abridged somatization construct. J Nerv Mental Dis 177:140–146Google Scholar
- Lipowski ZJ (1986) Somatization: a borderland between medicine and psychiatry. Can Med Assoc J 135:609–614Google Scholar
- Rief W, Greitemeyer M and Fichter MM (1991) Die Symptom Check List SCL-90R: Überprüfung an 900 psychosomatischen Patienten [The Symptom Check List SCL-90R: Evaluation of the results of 900 psychosomatic inpatients]. Diagnostica 37:58–65Google Scholar
- Rief W, Schäfer S and Fichter MM (1992) SOMS: ein Screening-Verfahren zur Identifizierung von Personen mit Somatoformen Störungen [SOMS — a screening instrument to identify subjects with somatoform disorders]. Diagnostica in pressGoogle Scholar
- Spitzer RL and Williams JB (1987) Structured clinical Interview for DSM-III-R (SCID) New York: Biometric Research Dep., NYS Psychiatric InstituteGoogle Scholar
- Spitzer RL, Williams JBW, Gibbon M and First MB (1990) SCID — Structured clinical interview for DSM-III-R, Washington: American Psychiatric PressGoogle Scholar
- Wittchen HU, Schramm E, Zaudig M, Spengler P, Rummler R and Mombour W (1990) Strukturiertes klinisches Interview für DSM-III-R. Weinheim Beltz TestGoogle Scholar