Explanatory models of somatoform disorder patients attending a psychiatry outpatient clinic: A study from North India

Abstract

The symptoms of somatoform disorders are very distressing to the sufferer as well as pose significant burden on the health-care delivery system. Although the nature of symptoms is physical, the underlying mechanisms are not clearly understood. The purpose of this study was to assess the explanatory models of patients with somatoform disorders presenting to a tertiary care hospital in Northern India. A total of 99 consecutive adult patients (≥ 18 years) with diagnosis of somatoform disorders according to the International Classification of Diseases-10th Revision (ICD-10) were evaluated for their explanatory models using the causal models section of Explanatory Model Interview Catalogue (EMIC). The mean age of the study sample was 36.52 years, and the mean duration of illness was 59.39 ± 57.68 months. The most common clinical diagnosis was that of persistent somatoform pain disorder. The most common explanations given belonged to the category of psychological factors (68.7%) followed by weakness (67.7%), social causes (51%) and karma-deed-heredity (53.5%) category. The mean number of etiological categories reported were 2.6 (standard deviation (SD) = 1.7). Among the various specific causes, the commonly reported explanations by one half of the sample in decreasing order were general weakness (63.6%), mind-thoughts-worry category (59.6%) and loneliness (53.5%). The mean number of specific etiologies was 4.9 (SD = 3.83). Most of the patients with somatoform disorder attribute their symptoms to psychological factors. It also becomes imperative to understand the physical symptoms in somatoform disorders from the sociocultural aspects of patients.