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The natural course of DSM-IV somatoform disorders and syndromes among adolescents and young adults: a prospective-longitudinal community study

Published online by Cambridge University Press:  16 April 2020

Roselind Lieb ,
Petra Zimmermann ,
Robert H Friis ,
Michael Höfler ,
Sven Tholen  and
Hans-Ulrich Wittchen
Roselind Lieb*
Affiliation:
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology Unit, Kraepelinstr 2, 80804, Munich, Germany
Petra Zimmermann
Affiliation:
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology Unit, Kraepelinstr 2, 80804, Munich, Germany
Robert H Friis
Affiliation:
Department of Health Science, California State University, Long Beach, A, USA
Michael Höfler
Affiliation:
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology Unit, Kraepelinstr 2, 80804, Munich, Germany
Sven Tholen
Affiliation:
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology Unit, Kraepelinstr 2, 80804, Munich, Germany
Hans-Ulrich Wittchen
Affiliation:
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology Unit, Kraepelinstr 2, 80804, Munich, Germany Department of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
*
*E-mail address:[email protected] (R. Lieb).
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Summary

Objective.

Although somatoform disorders are assumed to be chronic clinical conditions, epidemiological knowledge on their natural course based on representative samples is not available.

Method.

Data come from a prospective epidemiologic study of adolescents and young adults in Munich, Germany. Respondents’ diagnoses (N = 2548) at baseline and follow-up on average 42 months later are considered. The follow-up incidence, stability as well as selected baseline risk factors (sociodemographics, psychopathology, trauma exposure) for the incidence and stability of somatoform disorders and syndromes are prospectively examined. Diagnostic information was assessed by using the standardized Munich-Composite International Diagnostic Interview (M-CIDI).

Results.

Over the follow-up period, incidence rate for any of the covered somatoform diagnoses was 25.7%. Stability for the overall group of any somatoform disorder/syndrome was 48%. Female gender, lower social class, the experience of any substance use, anxiety and affective disorder as well as the experience of traumatic sexual and physical threat events predicted new onsets of somatoform conditions, while stability was predicted by being female, prior existing substance use, affective and eating disorders as well as the experience of a serious accident.

Conclusions.

At least for a substantial proportion of individuals, the overall picture of somatization seems to be relatively stable, but with fluctuation in the symptom picture over time. Being female, the experience of substance use as well as anxiety disorder seem to constitute risk factors for the onset of new somatoform conditions as well as for a stable course over time.

Keywords

Somatoform disordersAdolescenceEpidemiology
Type
Original article
Information
European Psychiatry , Volume 17 , Issue 6 , October 2002 , pp. 321 - 331
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington D.C: American Psychiatric Association; 1994.Google Scholar
Aro, HParonen, OAro, S. Psychosomatic symptoms among 14–16-year-old Finnish adolescents. Soc Psychiatry 1987; 22; 171–6.Google ScholarPubMed
Barsky, AJFama, JMBailey, ADAhern, DK. A prospective 4- to 5-year study of DSM-III-R hypochondriasis. Arch Gen Psychiatry 1998;55:737–44.Google ScholarPubMed
Barsky, AJWool, CBarnett, MCCleary, PD. Histories of childhood trauma in adult hypochondriacal patients. Am J Psychiatry 1994;151(3) 397–401.Google ScholarPubMed
Bland, RCNewman, SCOrn, H. Period prevalence of psychiatric disorders in Edmonton. Acta Psychiatr Scand 1988;77(Suppl 338):33–42.CrossRefGoogle Scholar
Escobar, JIBurnam, MAKarno, MForsythe, AGolding, JM. Somatization in the community. Arch Gen Psychiatry 1987;44:713–8.CrossRefGoogle Scholar
Escobar, JIGara, MSilver, RCWaitzkin, HHolman, ACompton, W. Somatization disorder in primary care. Br J Psychiatry 1998;173:262–6.CrossRefGoogle ScholarPubMed
Escobar, JIRubio-Stipec, MCanino, GKarno, M. Somatic symptom index (SSI): a new and abridged somatization construct. J Nerv Ment Dis 1989;177:140–6.CrossRefGoogle ScholarPubMed
Essau, CConradt, JPetermann, F. Häufigkeit und Komorbidität somatoformer Störungen bei Jugendlichen: Ergebnisse der Bremer Jugendstudie. Zeitschr Klin Psychol Psychother 2000;29(2):97–108.CrossRefGoogle Scholar
Garber, JWalker, LSZeman, J. Somatization symptoms in a community sample of children and adolescents: further validation of the Children’s Somatization Inventory. J Consult Clin Psychol 1991;3:588–95.Google Scholar
Gureje, OSimon, GE. The natural history of somatization in primary care. Psychol Med 1999;29:669–76.CrossRefGoogle ScholarPubMed
Hwu, HGYeh, EKChang, LY. Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule. Acta Psychiatr Scand 1989;79:136–47.CrossRefGoogle ScholarPubMed
Höfler, MLieb, RPerkonigg, ASchuster, PSonntag, HWittchen, H-U. Covariates of cannabis use progression in a representative population sample of adolescents: a prospective examination of vulnerability and risk factors. Addict 1999;94(11):1679–94.Google Scholar
Katon, WLin, EKorff von, MRusso, JLipscomb, PBush, T. Somatization: a spectrum of severity. Am J Psychiatry 1991;148:34–40.Google ScholarPubMed
Kent, DATomasson, KCoryell, W. Course and outcome of conversion and somatization disorders – a 4-year follow-up. Psychosom 1995;36(2):138–144.CrossRefGoogle Scholar
Kroenke, KPrice, RK. Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med 1993;153:2474–80.CrossRefGoogle ScholarPubMed
Kroenke, KSpitzer, RL. Gender differences in the reporting of physical and somatoform symptoms. Psychosom Med 1998;60:150–5.CrossRefGoogle ScholarPubMed
Kroenke, KSpitzer, RLDegruy, FHahn, SRLinzer, MWilliams, JBet al. Multisomatoform disorder. An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Arch Gen Psychiatry 1997;100:352–8.CrossRefGoogle Scholar
Lachner, GWittchen, HUPerkonigg, AHolly, ASchuster, PWunderlich, Uet al. Structure, content and reliability of the Munich-Composite International Diagnostic Interview (M-CIDI). Substance use sections. Eur Addict Res 1998;4(1–2):28–41.CrossRefGoogle ScholarPubMed
Lieb, RMastaler, MWittchen, H-U. Gibt es somatoforme Störungen bei Jugendlichen und jungen Erwachsenen? Erste epidemiologische Befunde der Untersuchung einer bevölkerungsrepräsentativen Stichprobe. Verhaltenstherapie – Praxis Forschung Perspektiven 1998;8:81–93.Google Scholar
Lieb, RPfister, HMastaler, MWittchen, H-U. Somatoform syndromes and disorders in a representative population sample of adolescents and young adults: prevalence, comorbidity and impairments. Acta Psychiatr Scand 2000;101:194–208.CrossRefGoogle Scholar
Lieb, RIsensee, BSydow von, KWittchen, HU. The early developmental stages of psychopathology study (EDSP), a methodological update. Eur Addict Res 2000;6:170–82.CrossRefGoogle Scholar
Perkonigg, AKessler, RCStorz, SWittchen, H-U. Traumatic events and posttraumatic stress disorder in the community: prevalence, risk factors and comorbidity. Acta Psychiatr Scand 2000;101:46–59.Google ScholarPubMed
Pribor, EFYutzy, SHDean, TWetzel, RD. Briquet's syndrome, dissociation, and abuse. Am J Psychiatry 1993;150:1507–11.Google Scholar
Reed, VGander, FPfister, HSteiger, ASonntag, HTrenkwalder, Cet al. To what degree the Composite International Diagnostic Interview (CIDI) correctly identifies DSM-IV disorders? Testing validity issues in a clinical sample. Int J Meth Psychiatr Res 1998;7(3): 142–155.CrossRefGoogle Scholar
Regier, DABoyd, JHBurke, JD JrRae, JDMyers, JKKramer, Met al. One month prevalence of mental disorders in the United States. Arch Gen Psychiatry 1988;45:977–86.CrossRefGoogle ScholarPubMed
Rief, WHessel, ABraehler, E. Somatization symptoms and hypochondriacal features in the general population. Psychosom Med 2001;63(4):595–602.CrossRefGoogle ScholarPubMed
Royall, RM. Model robust confidence intervals using maximum likelihood estimators. Int Statist Rev 1986;54:221–6.CrossRefGoogle Scholar
Simon, GEGureje, O. Stability of somatization disorder and somatization symptoms among primary care patients. Arch Gen Psychiatry 1999;56:90–5.CrossRefGoogle ScholarPubMed
Stata Corp: Stata Statistical Software: Release 7.0. College Station, TX: Stata Corporation. 2001.Google Scholar
Stein, MBFuetsch, MMüller, NHöfler, MLieb, RWittchen, H-U. Social anxiety disorder and the risk of depression. A prospective community study of adolescents and young adults. Arch Gen Psychiatry 2001;58:251–6.CrossRefGoogle ScholarPubMed
Swartz, MBlazer, DGeorge, LLanderman, R. Somatization in a community population. Am J Psychiatry 1986;143:1403–8.Google Scholar
Walker, EAKaton, WJHansom, JHarrop-Griffiths, JHolm, LJones, MLet al. Medical and psychiatric symptoms in women with childhood sexual abuse. Psychosom Med 1992;54:658–64.CrossRefGoogle ScholarPubMed
Wells, JEBushnell, JAHornblow, ARJoyce, PROakley-Browne, MA. Christchurch psychiatric epidemiology study, I: methodology and lifetime prevalence for specific psychiatric disorders. Aust New Zealand J Psychiatry 1989;23:315–26.CrossRefGoogle ScholarPubMed
Wittchen, H-UEssau, CAZerssen von, DKrieg, CJZaudig, M. Lifetime and six-month prevalence of mental disorders in the Munich follow-up study. Eur Arch Psychiatr Clin Neurosci 1992;241:247–58.CrossRefGoogle ScholarPubMed
Wittchen H-, ULachner, GWunderlich, UPfister, H. Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 1998;33:568–78.CrossRefGoogle Scholar
Wittchen, HULieb, RPfister, HSchuster, P. The waxing and waning of mental disorders: evaluating the stability of syndromes of mental disorders in the population. Comprehensive Psychiatry 2000;41:122–32.CrossRefGoogle ScholarPubMed
Wittchen, H-ULieb, RSchuster, POldehinkel, T. When is onset? Investigations into early developmental stages of anxiety and depressive disorders. In: Rapoport, JL editor. Childhood onset of “adult” psychopathology, clinical and research advances. Washington D.C: American Psychiatric Press; 1999. p. 259–302.Google Scholar
Wittchen, H-UPerkonigg, ALachner, GNelson, CB. Early developmental stages of psychopathology study (EDSP): objectives and design. Eur Addict Res 1998;4(1–2): 18–27.CrossRefGoogle ScholarPubMed
Wittchen, HUPfister, H editors. DIA-X-Interviews: Manual für Screening-Verfahren und Interview; Interviewheft Längsschnittuntersuchung (DIA-X-Lifetime); Ergänzungsheft (DIA-X-Lifetime); Interviewheft Querschnittuntersuchung (DIA-X-12 Monate); Ergänzungsheft (DIA-X-12 Monate); PC-Programm zur Durchführung des Interviews (Längs- und Querschnittuntersuchung);Auswertungsprogramm. Frankfurt: Swets and Zeitlinger; 1997.Google Scholar
Wool, CABarsky, AJ. Do women somatize more than men? Psychosom 1994;35:445–52.Google ScholarPubMed
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