Telephonic survey and psychological aid for patients with somatic symptom disorders for the impact of lockdown and COVID-19 pandemic

OBJECTIVES: We describe the prevalence and perceived impact of life events reported by medically hospitalized patients with somatic symptom and related disorders (SSRD) and highlight patient characteristics and outcomes associated with highly impactful life events. METHODS: Retrospective chart reviews were conducted of patients with SSRD at a tertiary pediatric hospital who were seen by the psychiatry consultation service and completed various instruments while medically admitted, including a de novo life events checklist. Descriptive statistics, correlations, χ2 tests, and internal consistency analyses were used. RESULTS: Charts of 70.2% of patients with SSRD who completed the life events checklist (N = 172; age range 8–25 years) were reviewed. Of those studied, 94% reported at least 1 life event in the last year, with academic events most prevalent, 81% reported life events across multiple domains, and 56% perceived the life event(s) as having a great impact on their lives. Patients who perceived more great impact life events were older, from households with lower median incomes, had higher self-reported somatization, greater functional disability, more comorbid psychiatric diagnoses, required more psychotropic medications, and had longer medical admissions. CONCLUSIONS: Findings reveal that although the majority of medically hospitalized patients with SSRD reported at least 1 relevant life event, it was the patients’ perception of the impact of the life event(s) that correlated with high levels of disability and health care use. An assessment of the perception of life events in patients with SSRD may help hospitalists and interdisciplinary providers identify high-risk patients for whom early psychiatry referrals can be made.

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Triggers and Clinical Presentations of Functional Neurological Disorders: Lessons from World War 1

European Neurology ◽

10.1159/000507698 ◽

2020 ◽

Vol 83 (2) ◽

pp. 174-181

Author(s):

Stefanie Caroline Linden

Keyword(s):

Life Events ◽

Somatic Symptom ◽

Somatic Symptoms ◽

Symptom Clusters ◽

Physical Factors ◽

World War ◽

Combat Experience ◽

Female Patients ◽

Symptom Profiles ◽

Somatic Symptom Disorders

Introduction: The psychological contribution to functional neurological and somatic symptom disorders is a major topic in current medical debate. Objective: For an understanding of the processes leading to functional somatic symptoms, it is paramount to explore their relationship with stress and life events and to elucidate the contribution of cultural factors. Methods: A total of 937 case records of civilian and military patients with functional somatic disorders treated in London during World War 1 were analysed. Group differences in symptom profiles and contemporaneous diagnoses were tested with χ2 tests. Results: Paralyses and speech disturbances were significantly more common in soldiers (43.3 and 17.2% of cases) than in civilian male (28.1 and 6.5%) and female patients (32.4 and 7.5%), whereas female patients had the highest rates of pain (48.6%) and somatic symptoms (67%). Triggers were identified in around two-thirds of cases and included accidents, physical illness, and work stress, in addition to the combat experience of the soldier patients. The nature of the trigger influenced symptom expression, with acute (combat and noncombat) events being particularly prone to trigger loss of motor function. Symptom profiles showed a great deal of multi-morbidity and overlap, although some symptom clusters were more (motor and speech disturbance) or less common (pain and loss of energy) in soldiers than civilians. Triggering life events in civilians were similar to those reported by patients with somatic symptom disorders today, with an important role of physical factors. Patterns of multi-morbidity and symptom clusters also resembled those of modern cohorts. Conclusions: Analysis of historical records, illness trajectories, and treatments can enhance the understanding of the presentation, mechanisms, and course of functional neurological and related disorders and their consistency over time.

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Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive-compulsive disorder, trauma-related, and somatic symptom disorders

International Clinical Psychopharmacology ◽

10.1097/yic.0000000000000127 ◽

2016 ◽

Vol 31 (5) ◽

pp. 249-258 ◽

Cited By ~ 29

Author(s):

Umberto Albert ◽

Claudia Carmassi ◽

Fiammetta Cosci ◽

David De Cori ◽

Marco Di Nicola ◽

...

Keyword(s):

Anxiety Disorders ◽

Obsessive Compulsive Disorder ◽

Atypical Antipsychotics ◽

Somatic Symptom ◽

Clinical Implications ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Somatic Symptom Disorders

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Multiple Medication Use in Somatic Symptom Disorders: From Augmentation to Diminution Strategies

Polypharmacy in Psychiatry Practice, Volume I ◽

10.1007/978-94-007-5805-6_11 ◽

2012 ◽

pp. 243-254

Author(s):

Adrian P. Mundt

Keyword(s):

Somatic Symptom ◽

Medication Use ◽

Multiple Medication ◽

Somatic Symptom Disorders

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Neurocognitive dysfunctioning and the impact of comorbid depression and anxiety in patients with somatic symptom and related disorders: a cross-sectional clinical study

Psychological Medicine ◽

10.1017/s0033291717003300 ◽

2017 ◽

Vol 48 (11) ◽

pp. 1803-1813 ◽

Cited By ~ 7

Author(s):

Lars de Vroege ◽

Anique Timmermans ◽

Willem J. Kop ◽

Christina M. van der Feltz-Cornelis

Keyword(s):

Visual Memory ◽

Somatic Symptom ◽

Depression And Anxiety ◽

Neurocognitive Performance ◽

Information Processing Speed ◽

Comorbid Depression ◽

Health Care Centre ◽

Cross Sectional ◽

Neurocognitive Dysfunction ◽

The Impact

BackgroundThe prevalence and severity of neurocognitive dysfunctioning of patients with somatic symptom and related disorders (SSRD) is unknown. Furthermore, the influence of comorbid depression and anxiety has not been evaluated. This study examines neurocognitive dysfunctioning of patients with SSRD and explores if comorbid depression and anxiety is associated with specific neurocognitive dysfunctioning.MethodsCross-sectional study with consecutive patients suffering from SSRD visiting an outpatient specialty mental health care Centre of Excellence for SSRD. Extensive neuropsychological assessment and assessment of depression and anxiety symptom levels using the Patient-Health-Questionnaire-9 and General Anxiety Disorder questionnaire-7 were performed at intake. Multivariate analysis was performed.ResultsThe study sample consisted of 201 SSRD patients, with a mean age of 43 years (Standard deviation = 13) years; 37.8% were male. Neurocognitive dysfunction in the domains information processing speed, sustained and divided attention, working memory, verbal and visual memory were reported, compared with normative data. Comorbid depression and anxiety occurred frequently within the sample (75.1% and 65.7%, respectively). Neurocognitive dysfunctioning was worse in patients suffering from comorbid depression [multivariateF(7,161) = 2.839,p= 0.008] but not in patients with comorbid anxiety.ConclusionsPoor neurocognitive performance of patients with SSRD is common and worsens in case of comorbid depression. This may explain treatment dropout of patients with SSRD from neurocognitive behavioral therapy. Research on novel interventions is needed targeting neurocognitive functioning of patients with SSRD, particularly those with comorbid depression.

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Somatic Symptom and Related Disorders

10.1093/med/9780199326075.003.0010 ◽

2014 ◽

Author(s):

Kelli Jane K. Harding ◽

Brian A. Fallon

Keyword(s):

Somatic Symptom ◽

Body Dysmorphic Disorder ◽

Primary Care Patient ◽

Somatic Symptoms ◽

Conversion Disorder ◽

Physical Symptoms ◽

Care Patient ◽

Factitious Disorder ◽

The Difference ◽

Somatic Symptom Disorders

This chapter discusses the somatic symptom disorders, which are a heterogeneous group unified by physical symptoms or concerns that are associated with prominent distress or impairment. Somatic symptom disorders are estimated to account for 1 in 10 primary care patient visits. The relative prominence of somatic symptoms is essential to the difference between illness anxiety disorder, which is an example of the obsessional/cognitive subtype (not prominent) and somatic symptom disorder,, in which the somatic symptoms are prominent. Patients with body dysmorphic disorder, also an Obsessional/Cognitive subtype, are preoccupied with a perceived defect in physical appearance. Patients with conversion disorder (functional neurological symptom disorder) (dissociative sub-type) present with neurological symptoms that cannot be fully explained physiologically. Patients with factitious disorder consciously simulate illness for psychological purposes rather than practical gain.

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