Infection load as a predisposing factor for somatoform disorders: evidence from a Dutch General Practice Registry.

Abstract:

OBJECTIVE:Somatoform disorders (SDs) are characterized by chronic multiple functional somatic (FS) symptoms. It has been suggested that infections may be triggers for FS symptoms to occur, pointing to the immune system as a pathogenic factor in their development. The current study aimed to compare the prevalence of infections (i.e., infection load) in the history of patients with SDs with that of matched controls. METHODS:Samples (n = 185) were identified in the Psychiatric Case Register Middle Netherlands and the Julius General Practitioners Network. Patients with an SD diagnosis in the Psychiatric Case Register Middle Netherlands were compared with matched persons without somatoform complaints (controls) on their infection load in two periods before the date of the psychiatric diagnosis or a matched date for the controls (i.e., the total period for which data were available and a 3-year period). Infection load was defined as the total number of infections documented in the Julius General Practitioners Network. RESULTS:Patients with SD had significantly more infections than did controls in both periods (total period: mean [standard error] = 0.87 [0.10] versus 0.51 [0.06], z = -3.08, p = .002; 3-year period: 3.44 [0.47] versus 2.15 [0.50], z = -2.91, p = .004). CONCLUSIONS:Results show that patients with SD have a higher infection load preceding their diagnosis as compared with matched controls, implicating that infection load may indeed predispose for developing FS symptoms. These findings emphasize the importance of further research on immunological mechanisms in FS symptoms. Limitations of the study are discussed.

journal_name

Psychosom Med

journal_title

Psychosomatic medicine

authors

Lacourt TE,Houtveen JH,Smeets HM,Lipovsky MM,van Doornen LJ

doi

10.1097/PSY.0b013e3182a3d91f

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

759-64

issue

8

eissn

0033-3174

issn

1534-7796

pii

PSY.0b013e3182a3d91f

journal_volume

75

pub_type

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