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Psychiatric Illness in Patients with Persistent Somatisation

Published online by Cambridge University Press:  02 January 2018

Per Fink
Per Fink*
Affiliation:
Institute for Basic Psychiatric Research, Department of Psychiatric Demography, Aarhus Psychiatric Hospital, Skovagervej 2, DK-8240 Risskov, Denmark
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Abstract

Background

This study explores the incidence and nature of mental illness among persistent somatisers, and analyses their use of mental health services.

Method

Individuals with at least ten admissions to non-psychiatric departments during an 8-year period were studied. Persistent somatisers (n = 56) were compared with other frequent users (n = 57) of non-psychiatric services.

Results

Of the persistent somatisers, 82% had been examined by a psychiatrist at least once (median, 3 times). Sixteen per cent were mentally retarded, 48% were dependent on alcohol or drugs, and 48% had DSM–III–R personality disorder. The most prevalent ICD–10 diagnoses were anxiety states (54%), depressions (30%), phobias (18%) and psychoses (20%).

Conclusions

Persistent somatisation is associated with severe mental illness and a broad spectrum of heterogeneous psychiatric diagnoses and syndromes. Persistent somatisers impose a serious burden on the mental health care system.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 1 , January 1995 , pp. 93 - 99
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Barsky, A. J., Wyshak, G. & Klerman, G. L. (1992) Psychiatric comorbidity in DSM–III–R hypochondriasis. Archives of General Psychiatry, 49, 101–108.CrossRefGoogle ScholarPubMed
Bass, C. (1990) Somatization, Physical Symptoms and Psychological Illness. Oxford: Blackwell Scientific.Google Scholar
Bridges, K. W. & Goldberg, D. P. (1985) Somatic presentation of DSM–III psychiatric disorders in primary care. Journal of Psychosomatic Research, 29, 563–569.CrossRefGoogle ScholarPubMed
Dixon, W. J. (1985) BMDP Statistical Software Manual. Berkeley: University of California Press.Google Scholar
Dupont, A. (1983) A national psychiatric case register as a tool for mental health planning, research and administration: the Danish model. In Information Support to Mental Health Programs: An International Perspective (eds Laska, E. M., Gulbinat, W. H. & Regier, D. A.), pp. 257–274. New York: Human Sciences.Google Scholar
Escobar, J. I., Burnham, A., Karon, M., et al (1987) Somatization in the community. Archives of General Psychiatry, 44, 713–718.CrossRefGoogle ScholarPubMed
Everitt, B. S. (1977) The Analysis of Contingency Tables. New York: John Wiley.CrossRefGoogle Scholar
Fink, P. (1990) Mental illness and admission to general hospitals: a register investigation. Acta Psychiatrica Scandinavica, 82, 458–462.CrossRefGoogle ScholarPubMed
Fink, P. (1992a) The use of hospitalizations by persistent somatizing patients. Psychological Medicine, 22, 173–180.CrossRefGoogle ScholarPubMed
Fink, P. (1992b) Surgery and medical treatment in persistent somatizing patients. Journal of Psychosomatic Research, 36, 439–447.CrossRefGoogle ScholarPubMed
Fink, P. (1992c) Physical complaints and symptoms of somatizing patients. Journal of Psychosomatic Research, 36, 125–136.CrossRefGoogle ScholarPubMed
Ford, C. V. (1983) The Somatizing Disorders. Illness as a Way of Life. Amsterdam: Elsevier.Google Scholar
Goldberg, D. P. & Bridges, K. W. (1988) Somatic presentations of psychiatric illness in primary care setting. Journal of Psychosomatic Research, 32, 137–144.CrossRefGoogle ScholarPubMed
Guze, S. B., Woodryff, R. A. & Clayton, P. J. (1971) Hysteria and antisocial behavior: further evidence of an association. American Journal of Psychiatry, 127, 133–136.CrossRefGoogle ScholarPubMed
Guze, S. B., Cloninger, C. R., Martin, R. L., et al (1986) A follow-up and family study of Briquet's syndrome. British Journal of Psychiatry, 149, 17–23.CrossRefGoogle ScholarPubMed
Hagnell, O. & Rorsman, B. (1978) Suicide and endogenous depression with somatic symptoms in the Lundby study. Neuropsychobiology, 4, 180–187.CrossRefGoogle ScholarPubMed
Hansen, E. B. (1976) Paranoia Hypochondriaca. Monografi. Copenhagen: Copenhagen University Hospital.Google Scholar
Katon, W. (1984a) Panic disorder and somatization. Review of 55 cases. American Journal of Medicine, 77, 101–106.CrossRefGoogle ScholarPubMed
Katon, W., Kleinman, A. & Rosen, G. (1982) Depression and omatization: a review. Part I. American Journal of Medicine, 72, 127–135.CrossRefGoogle Scholar
Katon, W., Lin, E., Von Korff, M., et al (1991) Somatization: a spectrum of severity. American Journal of Psychiatry, 148, 34–40.Google ScholarPubMed
Lipowski, Z. J. (1988) Somatization: the concept and its clinical application. American Journal of Psychiatry, 145, 1358–1368.Google ScholarPubMed
Lipowski, Z. J. (1990) Somatization and depression. Psychosomatics, 31, 13–21.CrossRefGoogle ScholarPubMed
Liskow, B., Penick, E. C., Powell, B. J., et al (1986) In-patients with Briquet's syndrome: presence of additional psychiatric syndromes and MMPI results. Comprehensive Psychiatry, 27, 461–470.CrossRefGoogle Scholar
Morrison, J. (1989) Histrionic personality disorder in women with somatization disorder. Psychosomatics, 30, 433–437.CrossRefGoogle ScholarPubMed
Orenstein, H. (1989) Briquet's syndrome in association with depression and panic: a reconceptualization of Briquet's syndrome. American Journal of Psychiatry, 146, 334–338.Google Scholar
Rief, W., Schaefer, S., Hiller, W., et al (1992) Lifetime diagnoses in patients with somatoform disorders: which came first? European Archives of Psychiatry and Clinical Neuroscience, 241, 236–240.CrossRefGoogle ScholarPubMed
Swartz, M., Blazer, D., George, L., et al (1986) Somatization disorder in a community population. American Journal of Psychiatry, 143, 1403–1408.Google Scholar
Wing, J. K., Babor, T., Brugha, T., et al (1990) SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry, 47, 589–593.CrossRefGoogle ScholarPubMed
World Health Organization (1967) Manual of the International Statistical Classification of Disease, Injuries, and Causes of Death, 1965 revision (8th edn) (ICD–8). Geneva: WHO.Google Scholar
World Health Organization (1991) SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Geneva: WHO.Google Scholar
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