-
JAMA Otolaryngology-- Head & Neck... Sep 2017Somatization is a condition in which psychological distress is manifested by medically unexplained symptoms, and it is prevalent in all medical specialties, including...
IMPORTANCE
Somatization is a condition in which psychological distress is manifested by medically unexplained symptoms, and it is prevalent in all medical specialties, including otolaryngology. Recognition of somatization can be difficult, and there are limited methods available.
OBJECTIVES
To determine whether patients with somatization respond differently to the review of systems (ROS) portion of the patient interview and whether the ROS can be used to identify patients with somatization.
DESIGN, SETTING, AND PARTICIPANTS
A retrospective review of medical records of 2120 consecutive consultations of English- or Spanish-speaking patients aged 18 to 89 years who presented to the otolaryngology clinic from January 1, 2014, to November 10, 2015, was conducted to compare how the ROS of patients with chief complaints associated with somatization (group B: globus sensation, dizziness, and tinnitus) differs from those with symptoms more often associated with objective findings (group A: nasal obstruction, hoarseness, and hearing loss); a total of 605 patients were included. Objective clinical findings after physical examination and related testing were reviewed and classified as either significant, marginal, or absent. Current or past psychiatric comorbidities were also examined.
MAIN OUTCOMES AND MEASURES
Number of affirmative responses on a standardized, 69-point ROS was recorded as a ROS score (ROSS). Objective clinical findings, symptoms, and psychiatric comorbidities were recorded.
RESULTS
Of the 605 patients included in the analysis, 346 (57.2%) were women, and the mean (SD) age was 51.6 (15.7) years. Among patients with medically unexplained symptoms (median, 11; range, 0-39), the ROSS was higher compared with those with objective clinical findings (median, 6; range, 0-31) (median difference, 4; 95% CI, 3 to 6). Group A (hoarseness, nasal obstruction, and hearing loss: median ROSS, 6, range, 0-41) exhibited lower ROSS than group B (dizziness, globus sensation, and tinnitus: median ROSS, 9; range, 0-39) (median difference, -2; 95% CI -3 to -1). Psychiatric comorbidity (median, 10; range, 0-41) was associated with higher ROSS than patients without psychiatric comorbidity (median, 5.5; range, 0 to 36) (median difference, 5; 95% CI, 3 to 6).
CONCLUSIONS AND RELEVANCE
The manner in which patients respond to a standardized ROS differs in those with medically unexplained symptoms and in those with psychiatric disease. The ROS offers information beyond the actual systems review, and may be useful in the identification of somatization.
Topics: Female; Humans; Male; Medical History Taking; Medically Unexplained Symptoms; Mental Disorders; Middle Aged; Physical Examination; Retrospective Studies; Somatoform Disorders
PubMed: 28617903
DOI: 10.1001/jamaoto.2017.0671 -
Neuropsychiatric Disease and Treatment 2021Post-traumatic stress disorder (PTSD) has an adverse impact on the emotional health of prenatal maternal women and their offspring. During the Coronavirus Disease 2019...
INTRODUCTION
Post-traumatic stress disorder (PTSD) has an adverse impact on the emotional health of prenatal maternal women and their offspring. During the Coronavirus Disease 2019 (COVID-19) pandemic, pregnant women are vulnerable to traumatic events and are prone to PTSD symptoms. The aim of the study was to explore the predictive effects of insomnia and somatization on PTSD in pregnant women by utilizing generalized additive model (GAM).
MATERIALS AND METHODS
A total of 1638 pregnant women from three local cities in China underwent online survey on sleep quality, somatization, and PTSD symptoms tested by the Insomnia Severity Index (ISI), the subscale somatization of Symptom Checklist-90 (SCL-90-S) and the Checklist for DSM-5 (PCL-5), respectively.
RESULTS
Insomnia was positively correlated with PTSD symptoms in pregnant women ( = 1.79×10). Interestingly, insomnia and somatization showed a complex non-primary linear interaction in predicting PTSD ( = 2.00×10).
CONCLUSION
Our results suggest that insomnia is a prominent predictor of PTSD symptoms in pregnant women in the context of public emergencies. In addition, the effects of insomnia and somatization on PTSD symptoms are characterized by complex non-primary linear relationships.
PubMed: 34393483
DOI: 10.2147/NDT.S310300 -
Healthcare (Basel, Switzerland) Dec 2020The process of international migration causes a situation of vulnerability in people's health and greater difficulty in coping with disease. Furthermore, the adversities...
The process of international migration causes a situation of vulnerability in people's health and greater difficulty in coping with disease. Furthermore, the adversities suffered during migration can trigger reactive signs of stress and cause anxious, depressive, confusional and somatic symptoms. This article studies the relationships between psychosocial risk, psychological distress and somatization in immigrants from four communities: Maghrebis, Sub-Saharans, South Americans and South Asian. A cross-sectional study was carried out with questionnaires on 602 immigrants who were surveyed in the primary care centers of an urban area of Catalonia. The instruments used were the Demographic Psychosocial Inventory (DPSI), the Brief Symptom Inventory (BSI) and the Somatic Symptom Inventory (SSI). The average psychosocial risk obtained was 0.35, with the highest values in the Sub-Saharan community. Psychological distress showed a mean value of 0.66, with the Sub-Saharan community scoring the lowest in all dimensions except depression. The average somatization values were 1.65, with the Sub-Saharan community scoring the least. The female gender is a risk factor for somatization and psychological distress. Perceived psychosocial risk is a predictor of psychological distress, but not somatization, suggesting that the use of more adaptive coping strategies could minimize the effect of the migration process on somatizations.
PubMed: 33322209
DOI: 10.3390/healthcare8040557 -
Acta Medica Portuguesa 2011The authors have brought together and analised texts about the history of the concept of hysteria. In these texts hysteria is fundamentally considered a disease of... (Review)
Review
The authors have brought together and analised texts about the history of the concept of hysteria. In these texts hysteria is fundamentally considered a disease of organic origin (of the womb), and, in the Middle Age, evidence of demonic possession. From the XVII century onwards, apart from the etiopathogenic concepts, also taken into consideration are aspects connected to the differential diagnosis with other similar entities and the therapy used each period. Even, in subsequent centuries, authors such as Syndenham, who consider hysteria to be a multidimensional entity, are rare. Empiricism has contributed to discoveries in biology and physiology, both general and of the nervous system itself, and given birth to the formulation of the Spinal Irritation Theory and Reflex Theory. These theories have led to strictly organic treatment of hysteria, in the same way that hysterectomies were performed to alleviate somatic symptoms connected to this disease. The introduction of hypnosis in medical practice, with Charcot in X1X century, allowed for the element of suggestion to be observed ( a non organic element) which accompanies the symptoms of hysteria. Two of his disciples, Janet and Freud, would define and isolate psychic mechanisms in the symptoms of hysteria: Dissociation of the consciousness (Janet) and Conversion (Freud). The last one developed a therapeutic method of a psychological nature for hysteria. The therapeutic implications and the pertinence of the distinction between unspecific somatization or functional (of somatic origin) somatization and somatization linked to disassociation mechanisms and conversion (psychic origin) are discussed as well as the evolution of international classification systems of somatization and the questions posed by the algorithms chosen for the cataloguing of symptoms. A revision of the relevant empirical studies about the association of somatization with depressive and anxiety disorders, within the general population, is made. The characteristics that permeate the clinical descriptions of somatoform disorders (whose validity criteria remain weak) and are not integrated within the diagnostic criteria for somatoform disorders are considered. We draw conclusions about the difficulties and consequences of the changes that some authors advocate in relation to the new classification system for somatoform syndromes.
Topics: Humans; Hysteria; Somatoform Disorders
PubMed: 22525627
DOI: No ID Found -
Noro Psikiyatri Arsivi Jun 2017This study aimed to establish the association between alexithymia and various factors, mainly somatization, and to determine the predictors of alexithymia in depressed...
INTRODUCTION
This study aimed to establish the association between alexithymia and various factors, mainly somatization, and to determine the predictors of alexithymia in depressed patients.
METHODS
A total of 90 patients with major depressive disorder who met The Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) diagnostic criteria were administered the Toronto Alexithymia Scale (TAS), Beck Depression Inventory, Symptom Checklist-90 (SCL-90), Somatosensory Amplification Scale, and Symptom Interpretation Questionnaire. The patients were classified into two groups as alexithymic and non-alexithymic with respect to the TAS cut-off points (≥59=alexithymic). Predictors of alexithymia were tested by multiple linear regression analysis.
RESULTS
Of all patients, 36 (40%) were in the alexithymic group. The percentage of women, depression severity, level of general psychopathology and distress, and somatic symptom reporting (SCL-90), as well as the tendency to somatosensory amplification and three forms of somatic symptom attributions, were significantly higher in alexithymic patients than in non-alexithymic patients. Furthermore, age, depression severity, somatic symptom reporting, and the tendency to attribute physical symptoms to somatic causes were predictors of alexithymia.
CONCLUSION
The results indicated an intimate association between alexithymia and somatization in depressed patients. Therefore, when evaluating depressed patients with alexithymia, their tendency for somatization should be considered, and alexithymic individuals should be assessed with particular attention, considering that somatization can mask the underlying depressive condition.
PubMed: 28680305
DOI: 10.5152/npa.2016.12385 -
Journal of Clinical Medicine Feb 2020The aim of this study was to identify correlations between sleep bruxism (SB) and temporomandibular disorders (TMD) as diagnosed by means of the research diagnostic...
The aim of this study was to identify correlations between sleep bruxism (SB) and temporomandibular disorders (TMD) as diagnosed by means of the research diagnostic criteria for temporomandibular disorders (RDC/TMD). Sleep bruxism was diagnosed on the basis of I) validated questionnaires, II) clinical symptoms, and III) electromyographic/electrocardiographic data. A total of 110 subjects were included in the study. Fifty-eight patients were identified as bruxers and 52 as nonbruxers. A psychosocial assessment was also performed. An RDC/TMD group-I diagnosis (myofascial pain) was made for 10 out of 58 bruxers, whereas none of the nonbruxers received a diagnosis of this type. No significant differences were found between bruxers and nonbruxers with regard to RDC/TMD group-II (disc displacement) and group-III (arthralgia, arthritis, arthrosis) diagnoses. Somatization was significantly more common among bruxers than nonbruxers. Multivariate logistic regression analysis revealed that somatization was the only factor significantly correlated with the diagnosis of myofascial pain. The results of this study indicate a correlation between myofascial pain, as diagnosed using the RDC/TMD, and somatization. It seems that somatization is a stronger predictor of an RDC/TMD diagnosis of myofascial pain than sleep bruxism is.
PubMed: 32102466
DOI: 10.3390/jcm9020611 -
Social Science & Medicine (1982) Oct 2020Psychological resilience is characterized as the ability to respond to extreme stress or trauma or adverse experience successfully. While the relation between public...
RATIONALE
Psychological resilience is characterized as the ability to respond to extreme stress or trauma or adverse experience successfully. While the relation between public emergencies and psychological distress is well known, research on therelationship between psychological resilience and mental health is very limited during the outbreak of public health emergencies.
OBJECTIVE
This research investigated the relationship between psychological resilience and mental health (depression, anxiety, somatization symptoms) among the general population in China.
METHOD
Psychological resilience, depression, anxiety, and somatization symptoms of 1770 Chinese citizens were investigated during the epidemic peak of coronavirus disease 2019 (COVID-19) (23rd February 2020 to 2nd March 2020). The analyses were done through the Connor-Davidson Resilience Scale (CD-RISC), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) scale, and the Patient Health Questionnaire-15 (PHQ-15) scale.
RESULTS
The prevalence of depression, anxiety, somatization symptoms was found to be 47.1%, 31.9%, 45.9%, respectively, among all participants. From them, 18.2% showed moderate to severe symptoms of depression, 8.8% showed moderate to severe symptoms of anxiety, and 16.6% showed moderate to severe symptoms of somatization. Psychological resilience was negatively correlated with depression (standardized β = -0.490, P < 0.001), anxiety (standardized β = -0.443, P < 0.001), and somatization symptom scores (standardized β = -0.358, P < 0.001), while controlling for confounding factors. Analysis of the three-factor resilience structure showed that strength and tenacity were correlated with depression (standardized β = -0.256, P < 0.001; standardized β = -0.217, P < 0.001), anxiety (standardized β = -0.268, P < 0.001; standardized β = -0.147, P < 0.001), and somatization symptoms (standardized β = -0.236, P < 0.001; standardized β = -0.126, P < 0.01).
CONCLUSIONS
Our results suggest that there is a high prevalence of psychological distresses among the general population at the peak of the COVID-19 epidemic in China, which is negatively correlated with resilience. Psychological resilience represents an essential target for psychological intervention in a public health emergency.
Topics: Adult; Anxiety; COVID-19; China; Coronavirus Infections; Cross-Sectional Studies; Depression; Epidemics; Female; Humans; Male; Pandemics; Pneumonia, Viral; Resilience, Psychological; Somatoform Disorders
PubMed: 32758794
DOI: 10.1016/j.socscimed.2020.113261 -
Journal of Eating Disorders Mar 2022Disordered eating has been found to be associated with constructs involving self-repression, such as selflessness (the tendency to relinquish one's needs for others'),...
BACKGROUND
Disordered eating has been found to be associated with constructs involving self-repression, such as selflessness (the tendency to relinquish one's needs for others'), and concern for appropriateness (an alertness to information about social comparison and tendency to vary one's behavior in different social situations). This study aimed to examine associations between these self-repression variables and symptoms of general psychopathology for women and men in a community sample.
METHODS
Two hundred and thirty-six participants (92 men) aged 18-76 (M = 29.11 ± 10.10) volunteered to complete online measures of disordered eating, concern for appropriateness (cross-situational variability and attention to social comparison information), selflessness, and symptoms of depression, anxiety and somatization. Structural equation models were built to assess pathways between the study variables for men and women separately.
RESULTS
A MANOVA 2*7 design showed that women scored significantly higher than men on measures of selflessness, disordered eating and depression. For men, selflessness scores were positively and significantly associated only with depression scores. Cross-situational variability scores were positively associated with depression, somatization and anxiety scores. For women, selflessness scores were positively and significantly associated with depression, disordered eating, somatization and anxiety scores. Cross-situational variability scores were positively and significantly associated with depression, anxiety and somatization scores but not with disordered eating scores. Attention to Social Comparison Information scores were positively and significantly associated only with disordered eating scores.
CONCLUSIONS
Self-repression is more closely linked to psychopathology in women than in men. For men, self-suppression seems to be associated with symptoms of internalizing disorders, but not disordered eating. Even for women, it appears that self-repression is not connected exclusively with disordered eating, but with symptoms of psychopathology in general. Future research should explore why self-suppression plays such a central role in women's psychopathology.
PubMed: 35313987
DOI: 10.1186/s40337-022-00569-y -
Journal of Affective Disorders Dec 2020Somatization is a common comorbidity in anxious people. From January 31 to February 2, 2020, a high prevalence of moderate to severe anxiety was detected due to COVID-19...
BACKGROUND
Somatization is a common comorbidity in anxious people. From January 31 to February 2, 2020, a high prevalence of moderate to severe anxiety was detected due to COVID-19 outbreak. The purpose of this study was to investigate the prevalence and correlates of somatization among Chinese participants with anxiety receiving online crisis interventions from Feb 14 to Mar 29 during the COVID-19 epidemic.
METHODS
A total of 1134 participants who participated in online crisis interventions completed the Generalized Anxiety Disorder-7 (GAD-7) scale and the Symptom Checklist-90 (SCL-90) and demographic questions online. Somatization was defined as the average score of each item ≥ 2 in SCL-90 somatization subscale. Moderate to severe anxiety was defined as a score ≥ 10 in the GAD-7 scale.
RESULTS
Among all participants, 8.0% reported moderate to severe anxiety and 7.4% reported somatization. After March 1, the prevalence of anxiety with or without somatization did not significantly change (both p > 0.05), while the prevalence of somatization increased significantly (p < 0.01). Logistic regression analysis indicated that somatization was associated with chronic disease history (with an odds ratio of 4.80) and female gender (with an odds ratio of 0.33).
CONCLUSIONS
Our findings suggest that the history of chronic diseases is associated with somatization in individuals with anxiety, indicating some stress-related mechanisms. Chinese men in crisis intervention need more attention because they are more likely to report anxiety comorbid somatization.
Topics: Adolescent; Adult; Anxiety; Anxiety Disorders; Betacoronavirus; COVID-19; China; Chronic Disease; Comorbidity; Coronavirus Infections; Crisis Intervention; Cross-Sectional Studies; Female; Humans; Logistic Models; Male; Mental Health; Pandemics; Patient Health Questionnaire; Pneumonia, Viral; Prevalence; Risk Factors; SARS-CoV-2; Sex Factors; Somatoform Disorders; Young Adult
PubMed: 32866802
DOI: 10.1016/j.jad.2020.08.035 -
Neurogastroenterology and Motility Oct 2021The Rome IV criteria for disorders of gut-brain interaction define irritable bowel syndrome (IBS) as a functional bowel disorder associated with frequent abdominal pain...
Increased psychological distress and somatization in patients with irritable bowel syndrome compared with functional diarrhea or functional constipation, based on Rome IV criteria.
BACKGROUND
The Rome IV criteria for disorders of gut-brain interaction define irritable bowel syndrome (IBS) as a functional bowel disorder associated with frequent abdominal pain of at least 1 day per week. In contrast, functional diarrhea (FD) and functional constipation (FC) are relatively painless. We compared differences in mood and somatization between Rome IV IBS and FC/FD.
METHODS
A total of 567 patients with Rome IV defined IBS or FD/FC completed a baseline questionnaire on demographics, abdominal pain frequency, mood (hospital anxiety and depression scale, HADS), and somatization (patient health questionnaire, PHQ-12). The primary analysis compared differences in mood and somatization between IBS and FC/FD, and the relative influence of abdominal pain frequency on these extra-intestinal symptoms. The secondary analysis evaluated differences across individual IBS subtypes, and also between FC and FD.
KEY RESULTS
Patients with IBS-in comparison to those with FC/FD-had significantly higher mean PHQ-12 somatization scores (9.1 vs. 5.4), more somatic symptoms (6.0 vs. 4.3), abnormally high somatization levels (16% vs. 3%), higher HADS score (15.0 vs. 11.7), and clinically abnormal levels of anxiety (38% vs. 20%) and depression (17% vs. 10%). Increasing abdominal pain frequency correlated positively with PHQ-12, number of somatic symptoms, and HADS; p < 0.001. No differences in mood and somatization scores were seen between individual IBS subtypes, and nor between FC and FD.
CONCLUSION & INFERENCES
Based on the Rome IV criteria, IBS is associated with increased levels of psychological distress and somatization compared with FD or FC. Patients reporting frequent abdominal pain should be comprehensively screened for psychosomatic disorders, with psychological therapies considered early in the disease course.
Topics: Constipation; Diarrhea; Humans; Irritable Bowel Syndrome; Psychological Distress; Rome; Surveys and Questionnaires
PubMed: 33719130
DOI: 10.1111/nmo.14121