Determinants of health‐related quality of life in patients with persistent somatoform pain disorder

Petrak, Frank; Hardt, Jochen; Kappis, Bernd; Nickel, Ralf; Egle, U. T.

doi:10.1016/s1090-3801(03)00014-4

Cited by 36 publications

(29 citation statements)

References 24 publications

(28 reference statements)

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“…The presence of a personality disorder is related to more severe overall psychopathology and a reduced level of functioning [12] . Petrak et al [3] found health-related quality of life of patients with SPD strongly and significantly reduced compared with the general population. Thomassen et al [17] reported a signifi cant decrease in employment rates of somatoform disorder patients from 58% in the group aged between 20 and 29 years to 6% in the group aged between 50 and 59 years.…”

Section: Introductionmentioning

confidence: 99%

“…Somatization has been defi ned as the tendency to experience and communicate somatic distress in response to psychosocial stress and seek medical help for it [1] . It is possible that in SPD there is a heightened awareness of normal bodily sensations and a cognitive misinterpretation of physical symptoms as pain and illness [2,3] . Hyperarousal states and altered central nervous system information processing might be involved in the somatization process.…”

Section: Introductionmentioning

confidence: 99%

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Insomnia in Somatoform Pain Disorder: Sleep Laboratory Studies on Differences to Controls and Acute Effects of Trazodone, Evaluated by the Somnolyzer 24 × 7 and the Siesta Database

et al. 2005

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Patients with chronic pain often suffer from sleep disturbances, specifically decreased deep sleep, and thus may get into a vicious circle which maintains their pain condition. Utilizing polysomnography and psychometry, objective and subjective sleep and awakening quality was investigated in 11 patients with nonorganic insomnia (F51.0) related to somatoform pain disorder (SPD; F45.4) as compared with age- and sex-matched healthy controls of the Siesta normative database. Patients demonstrated a markedly deteriorated Pittsburgh Sleep Quality Index, a decreased Quality of Life Index, slightly increased self-reported anxiety (Zung SAS) and depression scores (Zung SDS), as well as an increased Epworth Sleepiness Scale and International Restless Legs Syndrome Scale score. Subjective sleep and awakening quality was markedly reduced, while somatic complaints were increased. Polysomnographic evaluation by a recently developed automatic sleep classifier (Somnolyzer 24 × 7) based on the rules of Rechtschaffen and Kales demonstrated reduced slow-wave sleep (SWS), the target variable in the present study, a decreased stage shift index, increased SWS latency and stage 4 sleep (S4) latency and an increased frequency of shifts from S2 to wakefulness (W) in patients as compared with controls. Minimal oxygen saturation was found decreased, periodic leg movements (PLMs) were increased. In the morning, patients showed deteriorated well-being, drive, mood and wakefulness. There were no significant noopsychic or psychophysiological differences between patients and controls (except for a reduced numerical memory and a slightly increased morning diastolic blood pressure in patients). Subsequent evaluation of the acute effects of 100 mg of a controlled-release formulation of trazodone (Trittico^® retard) in the patients demonstrated an increase in the target variable SWS, accompanied by a reduction in the number of awakenings and stage shifts. It normalized the frequency of shifts from S2 to W and reduced the frequency of shifts from W to S1, from S1 to S2, as well as from any stage to S1 and S2. Trazodone, however, also significantly reduced the total sleep period and S2 and increased the latency to S1. Moreover, the drug increased the reduced minimal O₂saturation, reduced the arousal index and the PLMs-in-wake index and normalized the increased morning diastolic blood pressure. In conclusion, our study demonstrated that SPD induced significant changes in subjective and objective sleep and awakening quality, which were partially mitigated by trazodone therapy. The data on the target variable SWS support our hypothesis of a key-lock principle in the diagnosis and drug treatment of sleep disorders. Our study provided the first evidence on the usefulness of the Somnolyzer 24 × 7 and the Siesta database in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Insomnia in Somatoform Pain Disorder: Sleep Laboratory Studies on Differences to Controls and Acute Effects of Trazodone, Evaluated by the Somnolyzer 24 × 7 and the Siesta Database

et al. 2005

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“…These results suggest that social support may figure as a coping assistance, and thereby result in increased activity levels [17]. Coping is associated with QOL, where strategies such as catastrophizing and avoidance are known to cause greater disruption of everyday life and negatively affect QOL [68,69]. The failure here to report an association between social support and physical QOL might be due to the relatively limited study period.…”

Section: Discussionmentioning

confidence: 72%

The influence of psychosocial factors on quality of life among women with pain: a prospective study in Sweden

2011

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“…Patients with somatoform pain disorder were also considerably impaired in terms of their physical and mental quality of life. This finding was particularly true of patients with unfavorable defense styles, pronounced pain behavior, and tendencies to regard life events as catastrophes (Petrak, Hardt, Kappis, Nickel, & Egle, 2003).…”

mentioning

confidence: 92%

Influence of childhood adversities and defense styles on the 1-year follow-up of psychosomatic- psychotherapeutic inpatient treatment

Nickel

Egle

2005

Psychotherapy Research

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Determinants of health‐related quality of life in patients with persistent somatoform pain disorder

Abstract: Patients with persistent somatoform pain disorder feel severely impaired. A clear pattern emerges for negative effects of the coping styles Increasing Pain Behaviors and Catastrophizing, while the identification of beneficial coping failed.

Cited by 36 publications

References 24 publications

Insomnia in Somatoform Pain Disorder: Sleep Laboratory Studies on Differences to Controls and Acute Effects of Trazodone, Evaluated by the Somnolyzer 24 × 7 and the Siesta Database

Insomnia in Somatoform Pain Disorder: Sleep Laboratory Studies on Differences to Controls and Acute Effects of Trazodone, Evaluated by the Somnolyzer 24 × 7 and the Siesta Database

The influence of psychosocial factors on quality of life among women with pain: a prospective study in Sweden

Influence of childhood adversities and defense styles on the 1-year follow-up of psychosomatic- psychotherapeutic inpatient treatment

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