Physical symptom attributions: a defining characteristic of somatoform disorders?

Abstract:

OBJECTIVES:We examined whether primary care patients were more likely to perceive a current health problem as 'physical illness only' as opposed to entailing psychological difficulties if they had a comorbid somatoform disorder compared to patients who had (a) both comorbid somatoform disorder and anxiety/depression or (b) comorbid anxiety and/or depression, and a reference group of (c) patients with well-defined physical disease. We examined whether attributions predicted future health expenditures. METHODS:A total of 1209 of 1785 patients completed questions on patient-perceived illness. The physicians diagnosed the current health problem. A stratified subsample was interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. Health expenditure was obtained from registers for a 2-year period. RESULTS:The belief that the current health problem was only physical was endorsed by 86% of patients presenting physical disease, 58% of patients with somatoform disorders, 29% of patients with both somatoform disorders and anxiety/depression and 24% of patients with anxiety or depressive disorders (χ2=269.2, df=3, P<.0001). In a multiple regression model, a 'physical illness only' perception predicted lower health expenditures [β = -0.31, 95% confidence interval (-0.55; -0.07), P=.013]. CONCLUSIONS:The prevalent assumption that physical symptom attributions are a central aspect in somatoform disorders is not supported by the current study.

journal_name

Gen Hosp Psychiatry

authors

Frostholm L,Ørnbøl E,Fink PK

doi

10.1016/j.genhosppsych.2015.01.002

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

147-52

issue

2

eissn

0163-8343

issn

1873-7714

pii

S0163-8343(15)00003-1

journal_volume

37

pub_type

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