SPECT Scan in Somatization Disorder Patients: An Exploratory Study of Eleven Cases

Purpose Somatization disorder has been described in several comorbid functional syndromes of urological chronic pelvic pain syndrome, such as irritable bowel syndrome. We investigated whether a subset of patients with urological chronic pelvic pain syndrome may have the polysymptomatic, polysyndromic presentation pattern that is common in somatization disorder. Materials and Methods A total of 70 male and female patients with urological chronic pelvic pain syndrome and 35 age matched controls without the syndrome completed a 59-item symptom checklist to assess the classic polysymptomatic, polysyndromic symptom pattern. The 2 operational tools used were the Perley-Guze derived symptom checklist and the somatic symptom algorithm used for Diagnostic and Statistical Manual, 4th Edition, Text Revision somatization disorder criteria. Results Female patients with urological chronic pelvic pain syndrome (interstitial cystitis/bladder pain syndrome) reported significantly more nonpain symptoms and pain symptoms outside the pelvis than control female urology patients (p = 0.0016 and 0.0018, respectively). Female patients with urological chronic pelvic pain syndrome were more likely to endorse a polysymptomatic, polysyndromic symptom pattern than female controls (27% vs 0%, p = 0.0071). In contrast, male patients with urological chronic pelvic pain syndrome (interstitial cystitis/bladder pain syndrome and/or chronic prostatitis/chronic pelvic pain syndrome) did not report more extrapelvic pain than male controls (p = 0.89). Male patients with urological chronic pelvic pain syndrome were not more likely than male controls to have a polysymptomatic, polysyndromic symptom pattern. Conclusions A subset of female patients with urological chronic pelvic pain syndrome endorses numerous extrapelvic symptoms across multiple organ systems. The checklist may be valuable to assess patients for this polysymptomatic, polysyndromic symptom pattern, which is common in somatization disorder. Recognizing this polysymptomatic, polysyndromic presentation will prompt clinicians to investigate further to determine whether somatization disorder may be an underlying diagnosis in a small subset of patients with urological chronic pelvic pain syndrome who complain of numerous extrapelvic symptoms.

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“…Advances in neural imaging may enhance our understanding of the interface between somatization disorder and functional somatic syndromes. 22,23 …”

Section: Discussionmentioning

confidence: 99%

Polysymptomatic, Polysyndromic Presentation of Patients With Urological Chronic Pelvic Pain Syndrome

et al. 2012

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“…Brain structural and functional alterations related to SD have been explored with neuroimaging techniques. For example, a single photon emission computed tomography study of patients with SD described hypoperfusion, primarily in the frontal, prefrontal, temporoparietal, and cerebellar areas (Garcia-Campayo et al, 2001). Also, in a positron emission tomography scanning study, somatization accompanied by anxiety was shown to be associated with decreased metabolism in brain regions, such as the ventrolateral prefrontal cortex, ventral anterior cingulate cortex (ACC) , and anterior insular gyrus (Brody et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Increased functional connectivity strength of right inferior temporal gyrus in first-episode, drug-naive somatization disorder

Yao

Jiang

et al. 2014

Aust N Z J Psychiatry

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Background: Evidence of brain structural and functional alterations have been implicated in patients with somatization disorder (SD). However, little is known about brain functional connectivity in SD. In the present study, resting-state functional magnetic resonance imaging (fMRI) and graph theory were used to obtain a comprehensive view of wholebrain functional connectivity and to investigate the changes of voxel-wise functional networks in patients with SD.Methods: Twenty-five first-episode, medication-naive patients with SD and 28 age-, sex-and education-matched healthy controls (HCs) underwent resting-state fMRI. The graph theory approach was employed to analyze the data.Results: Compared to the HCs, patients with SD showed significantly increased functional connectivity strength in the right inferior temporal gyrus (ITG). There is a significant positive correlation between the z-values of the cluster in the right ITG and Hamilton Anxiety Scale scores. Conclusions:Our findings indicate that there is a disruption of the functional connectivity pattern in the right ITG in first-episode, treatment-naive patients with SD, which bears clinical significance.

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“…Like functional cognitive deficits, functional brain changes have not only been described in psychiatric disorders with an organic or "endogenous" origin, but also in conditions perceived as "psychogenic", such as somatization disorder. Hypoperfusion in several brain regions (cerebellum, temporoparietal, frontal, and prefrontal areas), predominantly in the nondominant hemisphere, was demonstrated in SPECT imaging of 11 patients with somatization disorder (50). A F-18 FDG PET study of 10 female patients with severe somatization revealed reductions in glucose metabolism in the caudate nuclei on both sides, in the left putamen, and the right precentral gyrus (51).…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological and positron emission tomography correlates in idiopathic environmental intolerances

Bornschein¹,

Hausteiner²,

Drzezga³

et al. 2007

Scand J Work Environ Health

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SPECT Scan in Somatization Disorder Patients: An Exploratory Study of Eleven Cases

Abstract: A proportion of SD patients may present hypoperfusion in SPECT images, uni- or bilaterally, in different brain areas. Possible aetiological explanations for this finding are discussed. Controlled studies are necessary to confirm or refute this hypothesis.

Cited by 45 publications

References 22 publications

Polysymptomatic, Polysyndromic Presentation of Patients With Urological Chronic Pelvic Pain Syndrome

Polysymptomatic, Polysyndromic Presentation of Patients With Urological Chronic Pelvic Pain Syndrome

Increased functional connectivity strength of right inferior temporal gyrus in first-episode, drug-naive somatization disorder

Neuropsychological and positron emission tomography correlates in idiopathic environmental intolerances

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