Principles of Psychosomatic Assessment

Fava, Giovanni A.; Sonino, Nicoletta; Wise, Thomas N.

doi:10.1159/000329997

Cited by 34 publications

(31 citation statements)

References 135 publications

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“…Psychosomatic assessment and treatment of medical comorbidities is relevant in depression in general [57,58,59], but may be more important in some subtypes than others [26,60]. Our findings indicate that clinicians should be particularly attentive to medical morbidity, in patients with non-psychotic severe depression, and emphasize the importance of clinically relevant subtypes of the highly heterogeneous depressive syndrome [26,61,62].…”

Section: Discussionmentioning

confidence: 86%

The Association between Physical Morbidity and Subtypes of Severe Depression

Østergaard

Petrides

Dinesen

et al. 2012

Psychother Psychosom

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Background: Physical illness and depression are related, but the association between specific physical diseases and diagnostic subtypes of depression remains poorly understood. This study aimed to clarify the relationship between a number of physical diseases and the nonpsychotic and psychotic subtype of severe depression. Methods: This is a historical prospective cohort study. The study population consisted of all patients diagnosed with ICD-10 severe depression, either nonpsychotic or psychotic subtype, in Danish psychiatric hospitals between 1994 and 2008. The patients’ history of physical disease was assessed using the Danish National Patient Register. Using logistic regression it was investigated whether specific physical diseases were associated with relative increased risk for subsequent development of either the nonpsychotic or psychotic depressive subtype. Results: A total of 24,173 patients with severe depression were included in the study. Of those, 8,260 (34%) were of the psychotic subtype. A history of the following physical diseases, as opposed to their absence, increased the relative risk for subsequent development of the nonpsychotic compared to the psychotic depressive subtype [adjusted incidence odds ratio (AIOR) nonpsychotic vs. psychotic]: ischemic heart disease (AIOR = 1.3, p < 0.001), hypertension (AIOR = 1.2, p = 0.008), stroke (AIOR = 1.2, p = 0.042) and chronic lower pulmonary disease (AIOR = 1.2, p = 0.005). The total load of physical disease also increased the relative risk of nonpsychotic depression [AIOR = 1.05 (per disease), p = 0.001]. Conclusions: This study revealed that, in severe depression, a history of physical disease increased the relative risk of the nonpsychotic rather than the psychotic subtype.

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Section: Discussionmentioning

confidence: 86%

The Association between Physical Morbidity and Subtypes of Severe Depression

Østergaard

Petrides

Dinesen

et al. 2012

Psychother Psychosom

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“…On the other hand, in the medical setting, the traditional biomedical disease model cannot explain how recognition, presentation, and outcome of a disease may be largely influenced by individual responses to symptoms [11] . Many years ago, Feinstein [68] already urged clini-cians to develop alternative intellectual models to study the clinical phenomena directly, to specify the importance of different types of clinical data, and to create appropriate systems of taxonomy for classifying the information that would articulate the clinical process and use the results for quantified analyses for enhancing the process of clinical decision making.…”

Section: Resultsmentioning

confidence: 99%

“…material, see www.karger.com/doi/10.1159/000430788). The DCPR rationale was to expand the traditional domains of the disease model by translating psychosocial variables that derived from psychosomatic research into operational tools [10,11] . The DCPR are a set of 12 psychosomatic syndromes whose prognostic role in the development, course, and outcome of physical diseases, regardless of their 'organic' or 'functional' nature, was documented by a large body of literature.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Utility of the Diagnostic Criteria for Psychosomatic Research: A Review of Studies

Porcelli

Guidi

2015

Psychother Psychosom

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Background: The Diagnostic Criteria for Psychosomatic Research (DCPR) are a set of 12 psychosomatic syndromes and are provided with a reliable diagnostic structured interview. The DCPR have been proposed 20 years ago as an integrative assessment strategy that supplements the traditional psychiatric nosography for identifying patients within a given illness population whose psychosocial factors have clinical significance. This paper reviews their clinical utility, conceived as the degree and the amount of influence that the instrument has on multiple decisions and outcomes in clinical practice. Methods: Published reports which involved the use of the DCPR were identified by searching electronic databases. Studies which best displayed the clinical utility of the DCPR system were then selected and reviewed. Results: The DCPR system showed its clinical utility regarding the following clinical issues: (1) subtyping medical patients, (2) identifying subthreshold or undetected syndromes, (3) evaluating the burden of somatic syndromes, and (4) predicting treatment outcomes and identifying risk factors. Conclusions: The DCPR may help clinicians during the assessment process to recognize clinical conditions underlying symptom presentation, with important therapeutic and prognostic implications.

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“…Emmelkamp et al (84) have introduced the concept of macro-analysis (a relationship between co-occurring syndromes and problems is established on the basis of where treatment should commence in the fi rst place) in anxiety disorders. This method has been extended to mood disorders (56), psychosomatic assessment (85) and drug dependence (86). Macro-analysis starts from the assumption that in most cases there are functional relationships with other more or less clearly defi ned problem areas and that the targets of treatment may vary during the course of disturbances (56).…”

Section: Macro-analysismentioning

confidence: 99%