Psychiatric morbidity in patients with pain and medically unexplained symptoms

Abstract

Pain is the most common reason for patients to seek medical treatment and it is one of the main symptoms encountered in somatoform disorders. The aim of our study is to investigate psychiatric morbidity and phenomenology of pain and medically unexplained physical symptoms. A total of 90 patients who were referred to psychiatry clinic with somatic symptoms were included in the study. Patients were divided into three main groups based on their primary psychiatric diagnoses, i.e. somatoform disorders, anxiety disorders, and depressive disorders. The characteristics of pain and other medically unexplained somatic symptoms of the three groups were compared. It was observed that 84 patients met DSM-III-R criteria for at least one psychiatric disorder. The comparison of the three major diagnostic groups revealed that the major pain location was the chest area in anxiety disorders, while headache was the leading pain complaint in somatoform disorders. The patients with somatoform disorder and depressive disorder reported fatigue and extremity pain more frequently than the patients with anxiety disorder. On the other hand, headache and stomach ache were encountered more frequently in patients with somatoform disorder than in those with anxiety and depressive disorder. Our results showed that patients with unexplained chronic pain had a high psychiatric morbidity and, among the pain symptoms, headache and stomach ache were found to be specific to somatoform disorder.