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Somatisation disorder in primary care

Published online by Cambridge University Press:  03 January 2018

Javier I. Escobar ,
Michael Gara ,
Roxanne Cohen Silver ,
Howard Waitzkin ,
Alison Holman  and
Wilson Compton
Javier I. Escobar
Affiliation:
Department of Psychiatry, University of Medicine and Dentistry of New Jersey - Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
Michael Gara
Affiliation:
Department of Psychiatry, University of Medicine and Dentistry of New Jersey - Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
Roxanne Cohen Silver
Affiliation:
Department of Psychology and Social Behavior, School of Social Ecology, University of California, Irvine, California, USA
Howard Waitzkin
Affiliation:
Division of Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Alison Holman
Affiliation:
Department of Psychology and Social Behavior, School of Social Ecology, University of Irvine, California, USA
Wilson Compton
Affiliation:
Department of Psychiatry, Washington University, St Louis, Missouri, USA
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Abstract

Background

Somatisation is a common and frustrating clinical problem in primary care.

Method

Using structural diagnoses and functional measures, we examined the prevalence and associated features of somatisation disorder defined by three current nosologies and an abridged construct in subjects using primary care services.

Results

Somatisation disorder, diagnosed according to the standard criteria, was found to have a very low prevalence (range 0.06–5%), while more than one-fifth of the sample (22%) met the criteria for the abridged diagnosis. There was poor agreement between succeeding versions of the DSM system for identifying cases of somatisation disorder, each system ending up with rather disparate sets of individuals as well as variable levels of psychopathology and disability.

Conclusions

According to these data, standard somatisation disorder diagnoses add little to the prediction of disability/psychopathology beyond the contributions of an abridged construct of somatisation.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 3 , September 1998 , pp. 262 - 266
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Brook, R. H. (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Brook, R. H. (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Brook, R. H. Ware, J. E. Stewart, A. L. et al (1979) Conceptualization and Measurement of Health for Adults in the Health Insurance Study, Volume VII. Santa Monica, CA: and Corporation.Google Scholar
Escobar, J. I. (1997) Developing practical indexes of somatization in primary care. Journal of Psychosomatic Research, 42, 323–328.Google Scholar
Escobar, J. I. Burnam, M. A. Karno, M. et al (1987) Somatization in the community. Archives of General Psychiatry, 44, 713–719.Google Scholar
Escobar, J. I. Manu, P. Lane, T. et al (1989 a) Medically unexplained physical symptoms, somatization disorder and abridged somatization: studies with the diagnostic interview schedule. Psychiatric Developments, 3, 235–245.Google Scholar
Escobar, J. I. Rubio, M. Canino, G. et al (1989 b) Somatic Symptom Index (SSI): A new and abridged somatization construct: Prevalence and epidemiological correlates in two large community samples. Journal of Nervous and Mental Disease, 177, 140–146.Google Scholar
Feighner, J. P. Robins, E. Guze, S. B. et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Goldberg, D. P. & Bridges, K. (1988) Somatic presentation of psychiatric illnesses in primary care settings. Journal of Psychosomatic Research, 30, 137–144.Google Scholar
Goodwin, D. W. & Guze, S. B. (1994) Psychiatric Diagnosis. New York: Oxford University Press.Google Scholar
Gureje, O. Simon, G. E. Ustun, T. B. et al (1997) Somatization in cross-cultural perspective: A World Health Organization study in primary care. American Journal of Psychiatry, 154, 989–995.Google Scholar
Katon, W. Lin, E. & Von Korff, M. (1991) Somatization: A spectrum of severity. American Journal of Psychiatry, 148, 34–40.Google ScholarPubMed
Purtell, J. J. Robins, E. & Cohen, M. E. (1951) Observations on clinical aspects of hysteria. Journal of the American Medical Association, 146, 902–909.Google Scholar
Rief, W. Heuser, J. Mayrhuber, E. et al (1996) The classification of multiple somatoform symptoms. Journal of Nervous and Mental Disease, 184, 680–687.Google Scholar
Robins, L. N. Wing, J. Wittchen, H. U. et al (1988) The Composite International Diagnostic Interview. Archives of General Psychiatry, 45, 1069–1077.Google Scholar
Smith, G. R. (1990) Somatization Disorders in the Medical Setting, DHHS publication No. (Adm) 90–1631. Washington, DC: US Government Printing Office.Google Scholar
Smith, G. R. Rost, K. & Keshner, M. (1995) A trial of the effect of a standardized psychiatric consultation on health outcomes and costs in somatizing patients. Archives of General Psychiatry, 52, 238–243.CrossRefGoogle ScholarPubMed
Sullivan, M. Clerk, M. R. & Katon, W. J. (1993) Psychiatric and otologic diagnoses in patients complaining of dizziness. Archives of Internal Medicine, 153, 14791484.Google Scholar
Swartz, M. Landerman, R. George, L. et al (1990) Somatization disorder. In Psychiatric Disorders in America. (eds Reiger, D. A. & Robins, L. N.), pp. 220–257. New York: Free Press.Google Scholar
World Health Organization (1990) ICD–10 Chapter V, Mental and Behavioral Disorders–Diagnostic Criteria for Research. Geneva: WHO.Google Scholar
Swartz, M. (1992) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD–10). Geneva: WHO.Google Scholar
Yutzi, S. H. Cloinger, R. C. Guze, S. B. et al (1995) DSM–IV field trial: testing a new proposal for somatization disorder. American Journal of Psychiatry 152, 97–101.Google Scholar
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