Evaluating New Proposals for the Psychiatric Classification of Patients With Multiple Somatic Symptoms

Rief, Winfried; Mewes, Ricarda; Martin, Alexandra; Glaesmer, Heide; Brähler, Elmar

doi:10.1097/psy.0b013e318234eff6

Cited by 55 publications

(42 citation statements)

References 39 publications

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“…They are similar to the risk factors for persistent medically unexplained symptoms observed in the few relevant prospective studies [4,5,[35][36][37][38][52][53][54]. This probably reflects the fact that the majority of all somatic symptoms are usually categorised as "medically unexplained" [55][56][57][58][59].…”

Section: Discussionsupporting

confidence: 59%

The epidemiology of multiple somatic symptoms

Creed¹,

Davies²,

Jackson³

et al. 2012

Journal of Psychosomatic Research

177

147

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Section: Discussionsupporting

confidence: 59%

The epidemiology of multiple somatic symptoms

Creed¹,

Davies²,

Jackson³

et al. 2012

Journal of Psychosomatic Research

177

147

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“…It has been proposed to abandon the identification of MUS, as reporting multiple explained symptoms and MUS have similar health outcomes. Hence, research on multisymptomatology might be increasingly important, as this term may cover the phenomenon of MUS and somatisation in future definitions and classifications [7,15-17]. …”

Section: Introductionmentioning

confidence: 99%

Symptom load and functional status: results from the Ullensaker population study

et al. 2012

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BackgroundThere is evidence to support that the number of self-reported symptoms is a strong predictor of health outcomes. In studies examining the link between symptoms and functional status, focus has traditionally been on individual symptoms or specific groups of symptoms. We aim to identify associations between the number of self-reported symptoms and functional status.MethodsA questionnaire was sent to people in seven age groups (N = 3227) in Ullensaker municipality in Southern Norway. The Standardised Nordic Questionnaire and the Subjective Health Complaints Inventory were used to record 10 musculoskeletal symptoms and 13 non-musculoskeletal symptoms, respectively. Four COOP-WONCA charts were used to measure functional status.ResultsWe found a strong linear association between the number of self-reported symptoms and functional status. The number of symptoms explained 39.2% of the variance in functional status after adjusting for the effects of age and sex. Including individual symptoms instead of only the number of symptoms made little difference to the effect of musculoskeletal pain but affected the influence of non-muscular symptoms. Including even minor problems captured substantially more of the variance in functional status than including only serious problems.ConclusionsThe strong association between the number of symptoms and functional status, irrespective of type of symptom, might indicate that the symptoms share some common characteristics. The simple act of counting symptoms may provide an approach to study the relationships between health and function in population studies and might be valuable in research on medically unexplained conditions.

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“…The new criteria include health-related thoughts, feelings, and behaviours that are typical for somatization. Although good validity for the new proposals is shown by Rief, Mewes, Martin, Glaesmer, and Brähler (2011), there is still a lack of knowledge about dysfunctional cognitive styles of patients with somatoform disorders.…”

mentioning

confidence: 99%

Early maladaptive schemas in patients with somatoform disorders and somatization

Henker¹,

Keller²,

Reiss³

et al. 2019

Clin Psychology and Psychoth

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Maladaptive schemas are stable relational patterns that develop through harmful childhood experiences with primary caregivers. Schemas within somatoform disorders are rarely explored even though these disorders are clinically important due to high prevalence, co-morbidity, and cost for the health care system. This study investigates schemas according to Young's schema theory in patients with somatoform disorders in comparison with healthy controls and patients with depressive or anxiety disorders. Further associations between schemas and somatization were explored. We included 134 patients with a somatoform disorder and 39 age-matched healthy controls, 83 patients with a unipolar depression, and 34 patients with an anxiety disorder. The clinical sample consists of day care patients, diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, but without a personality disorder. Primary measures were the Young Schema Questionnaire (YSQ-S2), the Screening for Somatoform Disorders (SOMS-7T), the Beck Depression Inventory, Second Edition, and the Childhood Trauma Questionnaire. Analyses of variance indicated that somatoform patients scored higher onalmost all schemas than do healthy controls (p < 0.001, η 2 = 0.148). The highest mean scores were reached for the schemas "self-sacrifice" and "unrelenting standards," with significant higher values in the patient sample. However, when compared with patients with depressive or anxiety disorders, somatoform patients scored equally or even lower. High somatization was associated with generally higher schema activation. This effect was to a great extent mediated by depressive symptoms. Only the schema "vulnerability to harm or illness" was exclusively related to somatization.These findings suggest that schemas should be systematically assessed within psychotherapy of somatoform patients.

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Evaluating New Proposals for the Psychiatric Classification of Patients With Multiple Somatic Symptoms

Abstract: Whereas some validation criteria for the new proposals (including CSSD) are satisfactory, most of the new proposals are still restrictive.

Cited by 55 publications

References 39 publications

The epidemiology of multiple somatic symptoms

The epidemiology of multiple somatic symptoms

Symptom load and functional status: results from the Ullensaker population study

Early maladaptive schemas in patients with somatoform disorders and somatization

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