Syndrome stability and psychological predictors of symptom severity in idiopathic environmental intolerance and somatoform disorders

2006 ◽  
Vol 37 (2) ◽  
pp. 271-281 ◽  
Author(s):  
JOSEF BAILER ◽  
MICHAEL WITTHÖFT ◽  
CHRISTIANE BAYERL ◽  
FRED RIST
Keyword(s):  
Symptom Severity ◽  
Somatic Symptom ◽  
Somatoform Disorders ◽  
Somatic Symptoms ◽  
Control Group ◽  
Psychological Predictors ◽  
Idiopathic Environmental Intolerance ◽  
Somatosensory Amplification ◽  
Stable Conditions ◽  
Environmental Intolerance

Background. Previous studies suggest that idiopathic environmental intolerance (IEI) is a variant of somatoform disorders (SFDs) or the so-called functional somatic syndromes. Little is known, however, about the stability and the psychological predictors of IEI.Method. This prospective study examined the 1-year stability of somatic symptoms and IEI features in three diagnostic groups: 49 subjects with IEI, 43 subjects with SFD but without IEI, and 54 subjects (control group, CG) with neither IEI nor SFD. The predictive value of typical psychological predictors for somatization was tested using zero-order correlations and multiple linear regression analyses.Results. Somatic symptoms and IEI features proved to be temporally stable over the 1-year follow-up period. The SFD and IEI groups scored significantly higher than CG on all measures of somatic symptoms and on questionnaires assessing psychological predictors for somatization. Measures of trait negative affectivity (NA), somatic symptom attribution and somatosensory amplification predicted somatic symptom severity within the IEI and SFD groups, both at baseline and 1 year later. The strongest predictors of IEI complaints in the IEI group were somatic attributions, followed by prominent cognitions of environmental threat and a tendency to focus on unpleasant bodily sensations and to consider them as pathological.Conclusions. IEI and SFD are highly stable conditions. In both SFD and IEI, NA and the processes of symptom perception, interpretation and attribution contribute substantially to the persistence of typically somatoform symptoms and IEI complaints. Treatment of IEI and SFD should address these psychological factors and mechanisms.

Associations Between Posttraumatic Stress Symptoms, Anxiety Sensitivity, Socially Prescribed Perfectionism, and Severity of Somatic Symptoms Among Individuals with Fibromyalgia

Pain Medicine ◽  
2020 ◽  
Author(s):  
Hila Avishai Cohen ◽  
Gadi Zerach
Keyword(s):  
Risk Factors ◽  
Posttraumatic Stress ◽  
Symptom Severity ◽  
Somatic Symptom ◽  
Somatic Symptoms ◽  
Posttraumatic Stress Symptoms ◽  
Psychological Risk Factors ◽  
Stress Symptoms ◽  
Socially Prescribed Perfectionism ◽  
Psychological Risk

Abstract Objectives The contribution of psychological risk factors to the intensification of pain experienced among individuals with fibromyalgia syndrome (FMS) is relatively under-studied. The present study aims to explore associations between FMS-related somatic symptom severity and two personality tendencies: anxiety sensitivity (AS) and socially prescribed perfectionism (SPP). Furthermore, the relative contributions of these personality tendencies are examined vis-à-vis the experience of potentially traumatic events (PTEs) and the psychopathology of posttraumatic stress symptoms (PTSS). Methods A volunteer sample of 117 Israeli adults with FMS responded to online validated self-report questionnaires regarding their PTEs, PTSS, somatic symptom severity, FMS, AS, and SPP in a cross-sectional study. Results Participants’ self-reported PTSS rates (61.5%) were high. AS and SPP were positively related to somatic symptom severity. Interestingly, we found that PTSS positively predicted the severity of somatic symptoms above and beyond the contributions of AS and SPP. Conclusions The present study supports the assumption that psychological risk factors may affect the expression of somatic symptoms and the interpretation of pain stimulus arising in the body that might eventually be experienced as excessively painful. The study also suggests that above and beyond psychological risk factors, PTSS may express a high predominance and affect pain perception among participants with FMS.

scholarly journals Attachment and Crying in Patients with Medically Unexplained Somatic Symptoms

2019 ◽  
Vol 1 (12) ◽  
pp. 1065-1072
Author(s):  
R. Jansman ◽  
M. M. E. Riem ◽  
S. Broekhuizen-Dijksman ◽  
C. Veth ◽  
E. Beijer ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Somatic Symptom ◽  
Somatic Symptoms ◽  
Negative Attitude ◽  
Attachment Anxiety ◽  
Negative Attitudes ◽  
Medically Unexplained ◽  
History Of ◽  
And Behavior ◽  
Medically Unexplained Somatic Symptoms

AbstractMentalization deficits and disturbances in emotional functioning may contribute to somatization in patients with medically unexplained somatic symptoms (MUSS). The present study aimed to increase understanding the psychological factors that contribute to somatization by examining associations between attachment, crying attitudes and behavior, and somatic symptoms in these patients. Attachment security was measured with the Experiences in Close Relationships Questionnaire in sixty-eight outpatients diagnosed with MUSS. Somatic symptom severity was measured with the RAND-36, crying frequency, and attitudes with the Adult Crying Inventory. Patients were asked to evaluate photographs of crying individuals in order to assess the perception of crying and empathic responses to crying. Attachment anxiety was significantly related to somatic symptom severity and negative attitudes toward crying. In addition, somatic symptom severity was related to a more negative attitude toward crying and less awareness of the interpersonal impact of crying on others. The association between attachment anxiety and somatic symptoms was, however, not mediated by crying or negative attitude toward crying. Neither were there significant associations between attachment, somatic symptoms, and empathic responses to crying. Altered attitudes to crying may stem from a history of insecure attachment experiences and may reflect maladaptive emotion strategies in MUSS patients.

scholarly journals Efficacy of a guided internet-based intervention (iSOMA) for somatic symptoms and related distress in university students: study protocol of a randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024929 ◽  
Author(s):  
Severin Hennemann ◽  
Katja Böhme ◽  
Harald Baumeister ◽  
Eileen Bendig ◽  
Maria Kleinstäuber ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
University Students ◽  
Somatic Symptom ◽  
Controlled Trial ◽  
Somatic Symptoms ◽  
Symptom Burden ◽  
Control Group ◽  
Age Cohorts ◽  
Randomised Controlled ◽  
Internet Based Intervention

IntroductionPersistent and distressing somatic symptoms are common in younger age cohorts such as university students. However, the majority does not receive adequate psychosocial care. Internet-based and mobile-based interventions may represent low threshold and effective extensions to reduce somatic and associated mental symptom severity. The planned study aims to investigate the feasibility and efficacy of an internet-based intervention in reducing somatic and psychological symptoms in an international population of university students with somatic symptom burden.Methods and analysisThis parallel two-armed randomised controlled trial evaluates an 8-week guided intervention, including web-based consecutive modules based on cognitive behavioural therapy (CBT) principles against a waitlist control group. Guidance will be provided by trained psychologists with weekly written supportive feedback. As part of the ‘Studicare’ project, the present study aims to recruit n=154 university students indicating somatic symptom burden at baseline in German-speaking universities. Self-report assessments will take place at baseline and after intervention completion (8, 16 weeks after randomisation). The primary outcome will be the severity of somatic symptoms and associated mental distress. Secondary outcomes include depression, (health) anxiety, disability, intervention satisfaction and adherence.Ethics and disseminationEthics approval has been granted. Results from this study will be published in peer-reviewed journals and presented at international conferences.Trial registration numberDRKS00014375; Pre-results.

Evidence for Overlap Between Idiopathic Environmental Intolerance and Somatoform Disorders

2005 ◽  
Vol 67 (6) ◽  
pp. 921-929 ◽  
Author(s):  
Josef Bailer ◽  
Michael Witthöft ◽  
Christine Paul ◽  
Christiane Bayerl ◽  
Fred Rist
Keyword(s):  
Somatoform Disorders ◽  
Idiopathic Environmental Intolerance ◽  
Environmental Intolerance

scholarly journals Shared mental healthcare and somatization: changes in patient symptoms and disability

2015 ◽  
Vol 17 (03) ◽  
pp. 277-286 ◽  
Author(s):  
John M. Haggarty ◽  
Brian P. O’Connor ◽  
Jeremy B. Mozzon ◽  
S. Kathleen Bailey
Keyword(s):  
Primary Care ◽  
Symptom Severity ◽  
Somatic Symptom ◽  
Clinical Sample ◽  
Community Sample ◽  
Mental Healthcare ◽  
Self Report ◽  
World Health ◽  
Control Group ◽  
Functional Changes

AimTo describe the symptoms and functional changes in patients with high levels of somatization who were referred to an outpatient, multidisciplinary, shared mental healthcare (SMHC) service that primarily offered cognitive behavioural therapy. Second, we wished to compare the levels of somatization in this outpatient clinical sample with previously published community norms.BackgroundSomatization is common in primary care, and it can lead to significant impairment, disproportionate resource use, and poses a challenge for management.MethodsAll the patients (18+ years,n=508) who attended three or more treatment sessions in SMHC primary care over a seven-year period were eligible for inclusion to this pre–post study. Self-report measures included the Patient Health Questionnaire’s somatic symptom severity scale (PHQ-15) and the World Health Organization Disability Assessment Schedule (WHODAS II). Normative comparisons were used to assess the degree of symptoms and functional changes.FindingsClinically significant levels of somatization before treatment were common (n=138, 27.2%) and were associated with a significant reduction in somatic symptom severity (41.3% reduction;P<0.001) and disability (44% reduction;P<0.001) after treatment. Patients’ levels of somatic symptom severity and disability approached but did not quite reach the community sample norms following treatment. Multidisciplinary short-term SMHC was associated with significant improvement in patient symptoms and disability, and shows promise as an effective treatment for patients with high levels of somatization. Including a control group would allow more confidence regarding the conclusions about the effectiveness of SMHC for patients impaired by somatization.

scholarly journals Somatic symptom overlap in Beck Depression Inventory–II scores following myocardial infarction

2010 ◽  
Vol 197 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Brett D. Thombs ◽  
Roy C. Ziegelstein ◽  
Louise Pilote ◽  
David J. A. Dozois ◽  
Aaron T. Beck ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Beck Depression Inventory ◽  
Undergraduate Students ◽  
Somatic Symptom ◽  
Somatic Symptoms ◽  
Self Report ◽  
Patient Treatment ◽  
Control Group ◽  
Medically Ill ◽  
Severity Scores

BackgroundDepression measures that include somatic symptoms may inflate severity estimates among medically ill patients, including those with cardiovascular disease.AimsTo evaluate whether people receiving in-patient treatment following acute myocardial infarction (AMI) had higher somatic symptom scores on the Beck Depression Inventory–II (BDI–II) than a non-medically ill control group matched on cognitive/affective scores.MethodSomatic scores on the BDI–II were compared between 209 patients admitted to hospital following an AMI and 209 psychiatry out-patients matched on gender, age and cognitive/affective scores, and between 366 post-AMI patients and 366 undergraduate students matched on gender and cognitive/affective scores.ResultsSomatic symptoms accounted for 44.1% of total BDI–II score for the 209 post-AMI and psychiatry out-patient groups, 52.7% for the 366 post-AMI patients and 46.4% for the students. Post-AMI patients had somatic scores on average 1.1 points higher than the students (P<0.001). Across groups, somatic scores accounted for approximately 70% of low total scores (BDI–II <4) v. approximately 35% in patients with total BDI–II scores of 12 or more.ConclusionsOur findings contradict assertions that self-report depressive symptom measures inflate severity scores in post-AMI patients. However, the preponderance of somatic symptoms at low score levels across groups suggests that BDI–II scores may include a small amount of somatic symptom variance not necessarily related to depression in post-AMI and non-medically ill respondents.

scholarly journals Persistent unexplained physical symptoms: a prospective longitudinal cohort study in UK primary care

2019 ◽  
Vol 69 (681) ◽  
pp. e246-e253 ◽  
Author(s):  
Kethakie Lamahewa ◽  
Marta Buszewicz ◽  
Kate Walters ◽  
Louise Marston ◽  
Irwin Nazareth
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Symptom Severity ◽  
Somatic Symptom ◽  
Somatic Symptoms ◽  
Physical Symptoms ◽  
Factors Associated ◽  
Unexplained Physical Symptoms ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

BackgroundUnexplained physical symptoms (UPS) are extremely common among primary care attenders, but little is known about their longer-term outcome.AimTo investigate the persistence of somatic symptoms at 6 months among a cohort with multiple UPS, and identify prognostic factors associated with worsening symptom scores.Design and settingProspective longitudinal cohort study involving adults attending UK general practice in North and Central London between January and December 2013.MethodConsecutive adults attending nine general practices were screened to identify those with at least three UPS. Eligible participants completed measures of symptom severity (measured using the Patient Health Questionnaire Somatic Symptom Module [PHQ-15]), physical and mental wellbeing, and past health and social history, and were followed up after 6 months. Multivariable linear regression analysis was conducted to identify prognostic factors associated with the primary outcome: somatic symptom severity.ResultsOverall, 245/294 (83%) provided 6-month outcome data. Of these, 135/245 (55%) reported still having UPS, 103/245 (42%) had symptoms still under investigation, and only 26/245 (11%) reported complete symptom resolution. Being female, higher baseline somatic symptom severity, poorer physical functioning, experience of childhood physical abuse, and perception of poor financial wellbeing were significantly associated with higher somatic symptom severity scores at 6 months.ConclusionThis study has shown that at 6 months few participants had complete resolution of unexplained somatic symptoms. GPs should be made aware of the likelihood of UPS persisting, and the factors that make this more likely, to inform decision making and care planning. There is a need to develop prognostic tools that can predict the risk of poor outcomes.

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