Abstract
Background: Psychosomatic patients often complain of a variety of somatic symptoms. We sought to clarify the role of clinical predictors of complaints of somatic symptoms. Methods: We enrolled 604 patients visiting a psychosomatic outpatient clinic. The outcome was the total number of somatic symptoms, and the candidate clinical predictors were perceived psychosocial stress, alexithymia, somatosensory amplification, adaptation, anxiety, and depression. All participants completed questionnaires assessing the outcome and the predictors. Results: The average number of reported somatic symptoms was 4.8; the most frequent was fatigue (75.3%), followed by insomnia (56.1%), low-back pain (49.5%), headache (44.7%), and palpitations (43.1%). Multiple regression analysis showed that the total number of somatic symptoms was significantly associated with the degree of perceived psychosocial stress, alexithymia, somatosensory amplification, and depression. Also, structural equation models indicated links between excessive adaptation (via perceived psychosocial stress, alexithymia, and somatosensory amplification) and the total number of somatic symptoms. Conclusion: The results suggested that the association between psychosocial stress and reported somatic symptoms is mediated by alexithymia and somatosensory amplification in psychosomatic patients.
Highlights
When people are vulnerable to stress because of inherent characteristics and theirability to adapt, psychosomatic illness is likely to develop even if the stressors are mild or moderate [1]
In terms of gender differences, the total number of somatic symptoms and the Somatosensory Amplification Scale (SSAS) and Profile of Mood States (POMS) depression scale scores were significantly higher in females than in males
The total number of somatic symptoms was significantly associated with the Toronto Alexithymia Scale (TAS)-20, SSAS, Stress Perception Scale, and POMS depression scale scores
Summary
When people are vulnerable to stress because of inherent characteristics and their (in)ability to adapt, psychosomatic illness is likely to develop even if the stressors are mild or moderate [1]. Patients with psychosomatic illness often complain of a variety of somatic symptoms. The construct of somatosensory amplification is helpful when assessing the perceptual style of somatization and in conceptualization of psychosomatic illness. The outcome was the total number of somatic symptoms, and the candidate clinical predictors were perceived psychosocial stress, alexithymia, somatosensory amplification, adaptation, anxiety, and depression. Multiple regression analysis showed that the total number of somatic symptoms was significantly associated with the degree of perceived psychosocial stress, alexithymia, somatosensory amplification, and depression. Structural equation models indicated links between excessive adaptation (via perceived psychosocial stress, alexithymia, and somatosensory amplification) and the total number of somatic symptoms. Conclusion: The results suggested that the association between psychosocial stress and reported somatic symptoms is mediated by alexithymia and somatosensory amplification in psychosomatic patients
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