Advertisement

Somatoform symptoms in depressive and panic syndromes

  • Winfried Rief
  • Wolfgang Hiller
  • Manfred M. Fichter
Article

Abstract

Somatoform symptoms are common features of psychological and psychosomatic disorders. This study addresses the question of whether somatoform symptoms differ in patients with panic syndromes, with depressive syndromes, or with somatization syndromes without depression or panic syndromes. We therefore investigated 135 inpatients of a psychosomatic clinic and identified 64 patients for the depression group, 31 for the panic subgroup, and 18 for the somatization syndrome group. Neither the number of somatization symptoms nor the pattern of somatoform symptoms differed substantially among the 3 groups, except for higher frequencies of palpitations in the panic group and more abdominal pain symptoms in the depressive group. The 3 groups showed nearly identical frequency distributions of the individual somatoform symptoms. All 3 groups showed elevated hypochondriasis scores. In personality dimensions, depressive patients showed the lowest scores for extraversion. The improvements during inpatient treatment on the somatization variables, as well as general psychopathology, were also comparable. We favor the interpretation that the somatization syndrome is a fairly uniform syndrome whether or not it occurs alone or in combination with depressive syndromes or panic syndromes.

Key words

somatoform disorders somatization disorder panic disorder affective disorder abridged somatization disorder hypochondriasis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. American Psychiatric Association (1987).Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.Google Scholar
  2. American Psychiatric Association. (1994).Diagnostic and statistical manual of mental disorders (4th ed.). Washington. DC: Author.Google Scholar
  3. Angst, J., & Dobler-Mikola, A. (1985). The Zurich Study VI. A continuum from depression to anxiety disordersEuropean Archives of Psychiatry and Neurological Sciences.235 179–186.PubMedCrossRefGoogle Scholar
  4. Barsky, A. J., Wyshak, G., & Klerman, G. L. (1992). Psychiatric comorbidity in DSM-III-R hypochondriasis.Archives of General Psychiatry.49, 101–108.PubMedGoogle Scholar
  5. CIPS. (1986).Internationale SkalenfarPsychiatrie [International scales for psychiatry]. Weinheim, Germany: Beltz.Google Scholar
  6. Derogatis, L. R. (1977).SCL-90-R. Administration. scaring. and procedures manual far the revised version. Baltimore: Johns Hopkins University of Medicine.Google Scholar
  7. Escobar, J. I., Rubio-Stipec, M., Canino, G., & Karno, M. (1989). Somatic Symptom Index (SSI): A new and abridged somatization construct.Journal of Nervous and Mental Disease.177, 140–146.PubMedCrossRefGoogle Scholar
  8. Fahrenberg, J., Hampel, R., & Selg, H. (1989).Das Freiburger Personlichkeitsinventar FPI. 5. erganzte Auflage. Gottingen, Germany: Hogrefe.Google Scholar
  9. Fauman, M. A. (1994).Study guide to DSM-IV. Washington, DC: American Psychiatric Press.Google Scholar
  10. Feldman, L. A. (1993). Distinguishing depression and anxiety in self-report: Evidence from confirmatory factor analysis on nonclinical and clinical samples.Journal of Consulting and Clinical Psychology, 61, 631–638.PubMedCrossRefGoogle Scholar
  11. Hautzinger, M., & Bailer, M. (1992).Allgemeine Depressionsskala (ADS). Deutsche Form der Center for Epidemiological Studies Depression Scale (CES-D) Weinheim, Germany: Beltz. Test.Google Scholar
  12. Hiller, W., Rief, W., & Fichter, M. M., (in press), Further evidence for a broader concept of somatization disorder using the Somatic Symptom Index (SSI).Psychosomatics.Google Scholar
  13. Hiller, W., Zaudig, M., & von Bose, M. (1989). The overlap between depression and anxiety on different levels of psychopalhology.Journal of Affective Disorders.16, 223–231PubMedCrossRefGoogle Scholar
  14. Katon, W., Lin, E., Von Korff, M., Russo, J., Lipscomb, P., & Bush, P. (1991). Somatization. A spectrum of severity.American Journal of Psychiatry, 148, 34–40PubMedGoogle Scholar
  15. Kellner, R., Hernandez, J., & Pathak, D. (1992). Hypochondriacal fears and beliefs, anxiety, and somatisation.British Journal of Psychiatry, 160, 525–532.PubMedCrossRefGoogle Scholar
  16. King, R., Margraf, J., Ehlers, A., & Maddock, R. (1986). Panic disorder—overlap wish symptoms of somatization disorder. In I. Hand & H. U., Wittchen (Eds.),Panic and phobias (pp. 72–80). New York: Springer.Google Scholar
  17. Kirmyer, L. J., & Robbins, J. M. (1991). Three forms of somatization in primary care: Prevalence, co-occurrence, and sociodemographic characteristics.Journal of Nervous and Mental Disease, 179. 647–655.CrossRefGoogle Scholar
  18. Pilowsky, I. (1967). Dimensions of hypochondriasis.British Journal.of Psychiatry, 113, 89–93.PubMedCrossRefGoogle Scholar
  19. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population.Applied Psychological Measurement, 3, 385–401.CrossRefGoogle Scholar
  20. Rief, W., & Fichter, M. M. (1992). The Symptom Check List SCL-90-R and its ability to discriminate between dysthymia, anxiety disorders, and anorexia nervosa.Psychoputhology, 25, 128–138.CrossRefGoogle Scholar
  21. Rief, W., Hiller, W., Geissner, E., & Fichter, M. M. (1994). Hypochondrie—Erfassung und erste klinische Ergebnisse [Hypochondriasis—assessment and preliminary clinical results].Zeitschrift für Klinische Psychologie, 23, 34–42.Google Scholar
  22. Rief, W., Hiller, W., Geissner, E., & Fiehter, M. M. (in press). A two-year follow-up study of patients with somatoform disorders.Psychosomtltics.Google Scholar
  23. Rief, W., Schaefer, S.. & Fichter, M. M. (1992). SOMS—ein Screening-Verfahren zur Identifizierung von Personen mil somatoformen Storungen. [SOMS—a screening instrument to identify subjects with somatoform disorders].Diagnostica.38, 228–241.Google Scholar
  24. Rief, W., Sehaefar, S., Hiller, W., & Fichter, M. M. (1992). Lifetime diagnoses in patients with somatoform disorders—which came first?European Archives of Psychiatry and Clinical Neurascience.241, 236–240.CrossRefGoogle Scholar
  25. Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1990).SCID—structured clinical interview for DSM-III-R. Washington. DC: American Psychiatric Press.Google Scholar
  26. Wittchen, H. U., & Essau, C. A. (1989). Comorbidity of anxiety disorders and depression: Does it affect course and outcome?Journal of Psychiany and Psychobiology.4, 315–323.Google Scholar
  27. Wittchen, H. U., Essau, C. A., Rief, W., & Fichter, M. M. (1993). Assessment of somatoform disorders and comorbidity patterns with the CIDI—findings in psychosomatic inpatients.International Journal of Methods in Psychiatric Research, 3, 87–99.Google Scholar
  28. Wittchen, H. U., Schramm, E., Zaudig, M., Spengler, P., Rummler, R., & Mnmbour, W. (1990).SKID Strukturiertes klinisches Interview fur DSM-III-R. Weinheim, Germany: Beltz Test.Google Scholar
  29. World Health Organization. (1993).The ICD-10 classification of mental and behavioural disorders; Diagnostic criteria for research (DCR), Geneva: Author.Google Scholar

Copyright information

© International Society of Behavioral Medicine 1995

Authors and Affiliations

  • Winfried Rief
    • 1
  • Wolfgang Hiller
    • 1
  • Manfred M. Fichter
    • 1
  1. 1.Klinik Roseneck-Center for Behavioral Medicine, Prien am ChiemseeGermany and University of Munich-Psychiatric InstituteMunichGermany

Personalised recommendations