Prevalence Of Somatoform Disorders Research Articles

Transtornos somatoformes durante a pandemia de COVID-19

Objetivo: apresentar os transtornos somatoformes mais comumente observados na clínica médica diária, relacionando-os com a atual situação de pandemia da COVID-19. Métodos: foi realizada uma revisão bibliográfica descritiva e exploratória, de abordagem qualitativa, utilizando os bancos de dados PubMed, LILACS, SciELO e ScienceDirect; com os seguintes descritores: Somatização, Transtornos Somatoformes, Psicossomática, Hipocondria, Transtorno neurovegetativo, Dor crônica, Pandemia, Epidemia, COVID-19, Coronavírus e o boleano AND. Foram incluídas 18 referências no total. Resultados: A situação de pandemia e as medidas mais efetivas de contenção da doença, que são o isolamento e o distanciamento social, geram novos fatores estressantes aos indivíduos e estimulam o aparecimento ou o agravamento de transtornos somatoformes. Tais transtornos são divididos pela CID-10 em sete subtipos, que têm em comum sinais e sintomas somáticos sem explicação médica e provocam prejuízo no funcionamento cotidiano do indivíduo. É esperado que a incidência e prevalência dos transtornos somatoformes aumentem com a pandemia, e perdurem mesmo após a resolução da crise. Conclusões: É de grande importância que, diante do quadro pandêmico da COVID-19, os pacientes com transtornos somatoformes recebam uma atenção integral e apropriada, que considere os fatores biopsicossociais e espirituais próprios de cada indivíduo. Para tanto, é fundamental que os profissionais da saúde saibam reconhecer tanto as características específicas da doença quanto sua associação ao atual cenário, para que seja feito o diagnóstico e o tratamento adequados.

Somatoform disorders and medically unexplained symptoms in primary care.

The literature contains variable figures on the prevalence of somatoform disorders and medically unexplained symptoms in primary care. The pertinent literature up to July 2014 was retrieved by a systematic search in the PubMed/MEDLINE, PsychInfo, Scopus, and Cochrane databases. The methodological quality and heterogeneity (I2) of the retrieved trials were analyzed. The prevalence rates of medically unexplained symptoms, somatoform disorders, and their subcategories were estimated, along with corresponding 95% confidence intervals (CI), with the aid of random-effects modeling. From a total of 992 identified publications, 32 studies from 24 countries involving a total of 70 085 patients (age range, 15-95 years) were selected for further analysis. All had been carried out between 1990 and 2012. The primary studies were more heterogeneous overall; point prevalences for the strict diagnosis of a somatization disorder ranged from 0.8% (95% CI 0.3-1.4%, I2 = 86%) to 5.9% (95% CI 2.4-9.4%, I2 = 96%), with higher estimated prevalences in studies that applied less restrictive diagnostic criteria. At least one type of somatoform disorder was diagnosable by DSM-IV and/or ICD-10 criteria in a fraction of primary-care patients that ranged from 26.2% (95% CI 19.1-33.3%, I2 = 98%) to 34.8% (95% CI 26.6-44.6%; I2 = 92%). The percentage of patients complaining of at least one medically unexplained symptom ranged from 40.2% (95% CI 0.9-79.4%; I2 = 98%) to 49% (95% CI 18-79.8%, I2 = 98%). The quality of the studies, in general, was only moderate. No relationship was found between study quality and prevalence estimates. The statistical heterogeneity of the included studies is very high. Somatoform disorders and medically unexplained symptoms are more common than generally assumed. The found prevalences highlight the importance of these conditions in primary care.

How burdensome is the treatment of patients with somatoform disorders?

This study examines the influence of self-perceived emotional stress during the treatment of patients with somatoform disorders. It asks whether emotional stress can be influenced by psychosomatic education. Via online questionnaire general practitioners were asked about the prevalence of patients presenting with somatoform disorders and emotional stress during treatment. The prevalence of somatoform disorders in general practices was estimated at around 27.7 %. Practitioners educated in psychosomatic medicine estimate the prevalence of patients with somatoform disorders higher than practitioners without such education (n = 79; r = 0.242; p = 0.032). The treatment of patients presenting with somatoform disorders causes 42.6% more emotional stress among general practitioners compared with the treatment of an average patient (n = 79; t = 16.67; p ≤ 0.001). Doctors with additional education in psychosomatic medicine rate stress 17.2% lower than doctors without such education (n = 79; t = 1.875; p = 0.033). General practitioners experience the treatment of patients presenting with somatoform disorders as emotionally stressful. This emotional stress is mainly explained by increases in time expenditure, but it can be reduced by additional psychosomatic education.

The prevalence of somatoform disorders in internal medicine outpatient departments of 23 general hospitals in Shenyang, China

ObjectiveThe objective was to assess the prevalence, demographics and risk factors of somatoform disorders (SDs) in departments of internal medicine at 23 randomly selected general hospitals in Shenyang, China. MethodA two-stage screening process was followed based on an expanded Chinese version of the 12-item General Health Questionnaire and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders . A total of 5312 consecutive attendees of the outpatient at the departments of internal medicine were screened; 60 patients of 15 years or older were confirmed to have current SDs. ResultsThe 1-month prevalence of any type of SD was 1.56% [95% confidence interval (CI): 1.19%–2.02%], and those of undifferentiated SD, pain disorder, hypochondriasis and somatization disorder were 0.68% (0.47%–0.98%), 0.44% (0.15%–1.26%), 0.38% (0.22%–0.64%) and 0.06% (0.02%–0.20%), respectively. The prevalence of any SD and two types of SDs was higher in females than in males: relative risk (95% CI) for any SD=1.82 (1.11–2.97), for pain disorder=12.70 (1.63–99.19). ConclusionThe prevalence of SDs among outpatients at urban China's internal medicine departments is lower than that reported in most Western countries. SDs were more prevalent among female outpatients at general hospitals.

P-1369 - Prevalence of treated somatoform disorders among canadian children and adolescents: a population study

Objective In this study we examine among those under the age of 18 years having somatoform disorders, the relationship between physical health and mental health costs in comparison to those with other psychiatric disorders. Methods Based on approximately 10 Million billing records, we compared the average number of visits and average costs per unique individual for “physical diagnoses” (non-psychiatric) and psychiatric diagnoses over the 16 year study period across case and comparison groups. Here, we report the 16 year prevalence of somatoform disorders in the population. Results Somatoform disorders ranked 15 th in terms of overall cost in the comparison group which was randomly selected from the physician billing data pool. Somatoform disorders ranked 22 nd of 25 in terms of frequency of diagnosis. The cumulative frequency of somatoform disorders over the 16 year interval for individuals was 169 within the 26,392 cases and 479 within the 205,281 comparisons, representing approximately 0.8% of the sampled population total population in catchment ∼300,000). Discussion The prevalence of treated Somatoform disorders indicates that they are are relatively rare in the study population. Lieb et al. (2002) found a lifetime prevalence of 12.5% of any somatoform condition in German adolescents. Kebede and Alem (1999) reported a one month point prevalence of 2.5% for Ethiopian youth. Somatoform disorders are most commonly seen in children and adolescents and appeared to be diagnosed much less frequently among Canadian children and adolescents. Differences are likely based on sampling methodology used epidemiological surveys compared to population utilization.

Psychiatric disorders, body mass index and C-reactive protein in dialysis patients

Objective The objective of the study was to identify the prevalence of depression, anxiety and somatoform disorders in dialysis patients according to dialysis modality and to compare dialysis patients with and without psychiatric comorbidity regarding clinical characteristics, health-related quality of life (HRQoL) and markers of nutrition and inflammation. Methods One hundred and nine patients were assessed for depression, anxiety and somatoform disorder with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The Short Form 36 was used. Sociodemographic, clinical and laboratory data were collected. Results About one third, 30.3%, had a current psychiatric disorder regardless of dialysis modality (depression, 22%; anxiety, 17%; somatoform disorders, 1%), and these reported more impairment on HRQoL dimensions. In the multivariate analysis, significant correlations between psychiatric comorbidity and C-reactive protein (CRP≥6 mmol/L) [odds ratio (OR), 3.6; 95% confidence interval (CI), 1.3–9.9; P=.015] and body mass index (BMI≤21 kg/m 2) (OR, 4.2; 95% CI, 1.4–12.7; P=.011) were observed. Conclusion Depressive and anxiety disorders were common in dialysis patients and were associated with impaired HRQoL, while prevalence of somatoform disorders was low. A strong correlation between psychiatric comorbidity, CRP and BMI indicates that special attention should be given to patients with CRP≥6 mmol/L and BMI≤21 kg/m 2.

Validation of the PHQ-15 for Somatoform Disorder in the Occupational Health Care Setting

Introduction Within the occupational health setting, somatoform disorders are a frequent cause of sick leave. Few validated screening questionnaires for these disorders are available. The aim of this study is to validate the PHQ-15 in this setting. Methods In a cross-sectional study of 236 sicklisted employees, we studied the performance of the PHQ-15 in comparison with the Mini International Neuropsychiatric Interview (MINI) as golden reference standard. We approached employees who were sick listed for a period longer than 6 weeks and shorter than 2 years for participation. This study was conducted on one location of a large occupation health service in the Netherlands, serving companies with more than 500 employees. All employees who returned the PHQ-15 were invited for the MINI interview. Specificity and sensitivity were calculated for optimal cut point and a receiver operating characteristic (ROC) was constructed. Results A total of 107 participants consented to participate in the MINI interview. A non-response analysis showed no significant differences between groups. According to the MINI, the prevalence of somatoform disorders was 21.5%, and the most frequent found disorder was a pain disorder. The PHQ-15 had an optimal cut point of 9 (patients scoring 9 or higher (≥9) were most likely to suffer from a somatoform disorder), with specificity and sensitivity equal to 61.9 and 56.5%, respectively. ROCs showed an area under the curve (AUC) of 0.63. Conclusion The PHQ-15 shows moderate sensitivity but limited efficiency with a cut point of 9 and can be a useful questionnaire in the occupational health setting.

Gender Differences in Prevalence of Somatoform Disorders in Patients Visiting Primary Care Centers

The aim of this study was to examine the gender differences in the prevalence of somatoform disorders among a sample of Qatari patients who were visiting primary health care centers and to investigate the severity of diagnostic categories and the most frequent somatic symptoms in these patients. The first stage of the study was conducted with the help of general practitioners, using the somatic symptom module of the Patient Health Questionnaire 12-item General Health Questionnaire. Overall, 2320 subjects were approached, and a total of 1689 patients, of whom 892 were men and 797 were women, agreed to participate in the study. The prevalence rate of somatoform disorders among the total screened sample was 23.9%. The prevalence rate was slightly higher in Qatari women (24.2%) than in Qatari men (23.7%). Housewives (43.5%) and men in administrative posts (37.9%) reported higher somatic symptoms compared to other professions. Prolonged depressive reaction was significantly higher in women compared to men (P = .003). There was a significant gender difference in certain psychiatric diagnostic categories such as depressive episode, recurrent depressive disorder, dysthymia, and brief depressive reaction. Backache was the most common reported symptom in men, whereas headache was more common in women. The present study revealed that the prevalence of somatoform disorders in Qatar is as high as the overall prevalence reported in prior studies done in other primary care settings. The prevalence of somatoform disorders was slightly higher in Qatari women than in men.

P02-307 - Somatoform disorders problem in somatic health care system in Ukraine

At the present stage of a society development in Ukraine among based medical care problems the special priority has been provided the problem of somatoform vegetative disorders. A prevalence somatization clinical disturbances at patients with frustration various nosologic accessories and necessity of development of clinical criteria of differential diagnostics with somatic diseases were the precondition for studying this area. On the basis of complex study 727 patients of city policlinic and hospital are conducted determination of structure and prevalence of somatoform disorders in ambulatory-policlinic practice in the conditions of industrial center. Clinic-epidemiological and clinic-statistical research allowed to define the structure of somatoform disorders in ambulatory-policlinic practice. Organ neuroses with cardiorespiratory functional violations make 10%, organ neuroses with functional violations of gastrointestinal system 5,7%, organ neuroses with functional violations of the urinal system 12,2%. Set personality psychological, social-psychological and social constituents of somatoform disorders. On that ground has been developed complex level differentiated system of medical- psychological and psychotherapy correction of somatoform disorders with the 75% higt efficasy.

Somatoform disorders in vertiginous children and adolescents

Objective To investigate the frequency and characteristics of psychiatric co morbidity in a group of vertiginous children. Methods A retrospective review of patient notes between years 2000 and 2006 in the ENT clinic of Helsinki University Hospital. Patients were identified from the clinic database, based on hospital discharge codes. Results 119 children were examined because of vertigo. Nine vertiginous children had purely psychogenic vertigo. The main psychiatric diagnosis was depression. The prevalence of somatoform disorders was 2.5%. According to our study the main predictors of a psychogenic vertigo were constant or frequent vertigo usually with coexisting headaches, absence from school and problems with relationships at school or home. Conclusion Somatisation should always be kept in mind while dealing with vertiginous children. A thorough clinical work-up is needed to rule out potential illnesses, but as soon as the possibility of somatisation comes to mind, psychiatric consultation is recommended.

P03-71 Gender differences in prevalence of somatoform disorders in patients visiting primary care centers

Objective:The aim of this study was to examine the gender differences in the prevalence of somatoform disorders among a sample of Qatari patients who were visiting primary health care (PHC) centres and to investigate the severity of most frequent somatic symptoms in these patients.Method:The first stage of the study was conducted with the help of general practitioners (GPs), using the 12-item General Health Questionnaire (GHQ-12). the second stage was carried out by a psychiatrist using the Clinical Interview Schedule (CIS). the survey was conducted among patients presenting to the primary health care centres over the period from January to July, 2007. 2320 subjects were approached and a total of 1689 patientsagreed to participate and responded to the questionnaire. among the screened Qatari patients, 404 patients, 211 males (52.2%) and 193 females (47.8%), were identified for clinical interview.Results:The prevalence rate of somatoform disorders among the total screened sample was 23.9%. the prevalence rate was slightly higher in women (24.2%) than in men (23.7%). Prolonged depressive reaction was significantly higher in women compared to men (p=0.003). There was a significant gender difference in certain psychiatric diagnostic categories such as depressive episode, recurrent depressive disorder, dysthymia and brief depressive reaction. Backache was the most common reported symptom in men, while headache was more common in women.Conclusion:Prevalence of somatoform disorders was slightly higher in Qatari women than in men. There was a significant difference found between men and women in certain diagnosis categories and somatic symptoms.

Mental disorders in primary care: prevalence and co-morbidity among disorders. Results from the Functional Illness in Primary care (FIP) study

Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and socio-demographics are sketchy. A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18-65 years, consulting 28 family practices during March-April 2000 in Aarhus County, Denmark were screened, in the waiting room, for mental and somatic symptoms with SCL-8 and SCL-Somatization questionnaires, for illness worry with Whitely-7 and for alcohol dependency with CAGE. In a stratified random sample of 701 patients, physician interviewers established ICD-10 diagnoses using the SCAN interview. Prevalence was calculated using weighted logistic regression, thus correcting for sample skewness. Half of the patients fulfilled criteria for an ICD-10 mental disorders and a third of these for more than one group of disorders. Women had higher prevalence of somatization disorder and overall mental disorders than men. Men had higher prevalence of alcohol abuse and hypochondriasis than women. Psychiatric morbidity tended to increase with age. Prevalence of somatoform disorders was 35.9% (95% CI 30.4-41.9), anxiety disorders 164% (95% CI 12.7-20.9), mood disorders 13.5% (95% CI 11.1-16.3), organic mental disorders 3.1% (95% CI 1.6-5.7) and alcohol abuse 2.2% (95% CI 1.5-3.1). Co-morbidities between these groups were highest for anxiety disorders, where 89% also had another mental diagnosis, and lowest for somatoform disorders with 39%. ICD-10 mental disorders are very prevalent in primary care and there is a high co-occurrence between most disorders. Somatoform disorders, however, more often than not exist without other mental disorders.

Somatoform disorders in general practice: prevalence, functional impairment and comorbidity with anxiety and depressive disorders.

General practitioners play a pivotal part in the recognition and treatment of psychiatric disorders. Identifying somatoform disorders is important for the choice of treatment. To quantify the prevalence of, and functional impairment associated with, somatoform disorders, and their comorbidity with anxiety/depressive disorders. Two-stage prevalence study: a set of questionnaires was completed by 1046 consecutive patients of general practitioners (aged 25-80 years), followed by a standardised diagnostic interview (SCAN 2.1). The prevalence of somatoform disorders was 16.1% (95% CI 12.8-19.4). When disorders with only mild impairment were included, the prevalence increased to 21.9%. Comorbidity of somatoform disorders and anxiety/depressive disorders was 3.3 times more likely than expected by chance. In patients with comorbid disorders, physical symptoms, depressive symptoms and functional limitations were additive. Our findings underline the importance of a comprehensive diagnostic approach to psychiatric disorders in general practice.

Somatoform disorders in patients with musculoskeletal and cardiovascular diseases in comparison to the general population.

The present epidemiological study investigates sex- and age-adjusted 4-week, 12-month, and lifetime prevalence rates of somatoform disorders in in-patients with musculoskeletal and cardiovascular diseases in comparison with prevalence rates of these disorders in the general population in Germany. Prevalence rates were calculated from two samples, one from rehabilitation in-patients with musculoskeletal (n = 187) or cardiovascular (n = 116) diseases, and one from a large sample of the German National Health Interview and Examination Survey - Mental Health Supplement (GHS-MHS; n = 3889). The prevalence rates were based on the M-CIDI, an interview for the assessment of mental disorders. The adjusted prevalence rates of any mental disorder in both clinical samples are higher compared with rates of the general population (e.g. lifetime musculoskeletal, 59.3%; cardiovascular, 56.2%; general population, 47.9%). Prevalence rates of patients with cardiovascular (e.g. 12.2%) and musculoskeletal (21.5%) diseases do not indicate an increased prevalence of somatoform disorders compared with the general population (18.2%). The results confirm that patients with chronic somatic diseases have increased prevalence rates of mental disorders. However, these increased prevalence rates go primarily back to affective and anxiety disorders and not to somatoform disorders. The diagnostic criteria for somatoform disorders and the question algorithm of the M-CIDI are probably responsible for potential underestimation of somatoform disorders in patients with chronic somatic diseases.

Prevalence of Somatoform Disorders in Youth

In the Epidemiological Catchment Area (ECA) Study, lifetime prevalence of strictly defined somatization disorder was about 1% for adults; a slightly

Diagnosis, assessment and prevalence of somatoform disorders across cultures and settings

Diagnosis, assessment and prevalence of somatoform disorders across cultures and settings

Major mental disorders in Addis Ababa, Ethiopia. III. Neurotic and somatoform disorders.

This report presents estimates of the lifetime and point (one-month) prevalence of phobic anxiety, dissociative, other anxiety and somatoform disorders based on a survey conducted in Addis Ababa between September and December of 1994. An Amharic version of the CIDI was used to collect data from a random community sample of 1420 individuals aged 15 and above. Phobic anxiety disorders were found to be the most common of all anxiety disorders, with lifetime prevalence of 4.8%. The lifetime prevalence for dissociative disorders was 0.8% and for other anxiety disorders it was 2.7%. The prevalence of somatoform disorders was 3.1%. The lifetime prevalence for all the above neurotic and somatoform disorders was 10.8%. Point prevalence estimates (percent) for the disorders were as follows: phobic anxiety disorders, 4.4; other anxiety disorders, 1.2; dissociative disorders, 0.4; and somatoform disorders, 2.5. After adjusting for several potential confounders, women had over a two-fold risk of having neurotic and somatoform disorders compared to men, odds ratio (OR), 95% confidence interval (CI) = 2.38 (1.78, 3.12). Age was also inversely associated with the disorders. Those aged 60 and above had a 60% lower risk compared to those aged 15-24 years, OR (95% CI): 0.41 (0.20, 0.81). The 25% decreased risk for the employed, compared to the unemployed, was also not statistically significant. Education, marital status, and ethnicity were not significantly associated with neurotic and somatoform disorders.

Prevalence of somatoform disorders in a psychiatric population: an Italian nationwide survey. Italian Collaborative Group on Somatoform Disorders.

The survey involved 50 centres comprising both hospital and community psychiatric care services throughout Italy. Overall, 2620 patients were recruited, and of those 2002 (76%) completed the Somatoform Disorders Schedule (SDS), a CIDI-derived interview. The NOS somatoform disorders (SDs) diagnosis appeared to be the most common (60%) (and they showed the highest number of co-morbid diagnoses), followed by pain disorders (8%). The prevalence of undifferentiated somatoform and hypochondriactal disorders was 1.6%: older age groups showed a tendency towards higher rates of the latter. In general, the study found that a significant percentage of patients with SDs are referred to psychiatric services, but mainly because of other psychopathological problems: in fact, somatic complaints are cross-sectionally present in different psychiatric nosological categories. This study also emphasizes some limitations of the current classification of SDs.

Therapeutic models for somatoform disorders in liaison psychiatry

Somatoform disorders are usually supposed to be seen in the clinical field of consultation-liaison (C-L) psychiatry. This study reviewed medical records of physically ill inpatients who were also treated by psychiatrists for concurrent psychiatric illnesses during a 5-year period. The prevalence of somatoform disorders was 40 out of 1581 cases (2.5%), which was unexpectedly low. From the perspective of C-L psychiatry, the authors propose three therapeutic models for somatoform disorders: 1. physician-oriented with psychiatric advice; 2. psychiatrist-oriented; and 3. cooperative physician/psychiatrist-oriented. The third model is particularly recommended because the patient can undergo physical examinations until the relationship between somatic complaints and psychosocial factors is recognized. Moreover, the psychiatrist can build an alliance with a patient, while the patient completes a ‘testing phase’ to determine whether the psychiatrist can be relied on or not. The third model is useful as such and can be used at least in the initial phase.

Prevalence of Somatoform Disorders in a Large Sample of Patients With Anxiety Disorders

The authors investigated the prevalence and characteristics of somatoform (SOM) disorders among 654 subjects with anxiety disorders who were part of the larger Harvard/Brown Anxiety Disorders Research Project. Thirty-six (5.5%) of the subjects had past or current SOM disorders. The subjects with SOM disorders were significantly more likely to have histories of posttraumatic stress disorder (22% vs. 8%, P = 0.01). The subjects with generalized anxiety disorder had significantly higher rates of SOM disorder (9.2% vs. 4.0%, P = 0.01). These results add support to the observation that SOM disorders are frequently comorbid with anxiety and depressive disorders.