Somatic symptom disorder

About: Somatic symptom disorder is a research topic. Over the lifetime, 382 publications have been published within this topic receiving 119756 citations. The topic is also known as: somatic symptom disorder & psychosomatic disorder.

The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms.

Abstract: OBJECTIVE Somatization is prevalent in primary care and is associated with substantial functional impairment and healthcare utilization. However, instruments for identifying and monitoring somatic symptoms are few in number and not widely used. Therefore, we examined the validity of a brief measure of the severity of somatic symptoms. METHODS The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-15 comprises 15 somatic symptoms from the PHQ, each symptom scored from 0 ("not bothered at all") to 2 ("bothered a lot"). The PHQ-15 was administered to 6000 patients in eight general internal medicine and family practice clinics and seven obstetrics-gynecology clinics. Outcomes included functional status as assessed by the 20-item Short-Form General Health Survey (SF-20), self-reported sick days and clinic visits, and symptom-related difficulty. RESULTS As PHQ-15 somatic symptom severity increased, there was a substantial stepwise decrement in functional status on all six SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. PHQ-15 scores of 5, 10, 15, represented cutoff points for low, medium, and high somatic symptom severity, respectively. Somatic and depressive symptom severity had differential effects on outcomes. Results were similar in the primary care and obstetrics-gynecology samples. CONCLUSIONS The PHQ-15 is a brief, self-administered questionnaire that may be useful in screening for somatization and in monitoring somatic symptom severity in clinical practice and research.

The clinical basis of orthorexia nervosa: emerging perspectives

Abstract: Orthorexia nervosa describes a pathological obsession with proper nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. Although prompted by a desire to achieve optimum health, orthorexia may lead to nutritional deficiencies, medical complications, and poor quality of life. Despite its being a distinct behavioral pattern that is frequently observed by clinicians, orthorexia has received very little empirical attention and is not yet formally recognized as a psychiatric disorder. In this review, we synthesize existing research to identify what is known about the symptoms, prevalence, neuropsychological profile, and treatment of orthorexia. An examination of diagnostic boundaries reveals important points of symptom overlap between orthorexia and anorexia nervosa, obsessive–compulsive disorder (OCD), obsessive–compulsive personality disorder (OCPD), somatic symptom disorder, illness anxiety disorder, and psychotic spectrum disorders. Neuropsychological data suggest that orthorexic symptoms are independently associated with key facets of executive dysfunction for which some of these conditions already overlap. Discussion of cognitive weaknesses in set-shifting, external attention, and working memory highlights the value of continued research to identify intermediate, transdiagnostic endophenotypes for insight into the neuropathogenesis of orthorexia. An evaluation of current orthorexia measures indicates a need for further psychometric development to ensure that subsequent research has access to reliable and valid assessment tools. Optimized assessment will not only permit a clearer understanding of prevalence rates, psychosocial risk factors, and comorbid psychopathology but will also be needed to index intervention effectiveness. Though the field lacks data on therapeutic outcomes, current best practices suggest that orthorexia can successfully be treated with a combination of cognitive-behavioral therapy, psychoeducation, and medication.

Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale

Abstract: Objective:Dissociation is a complex, ubiquitous construct in psychopathology. Symptoms of dissociation are present in a variety of mental disorders and have been connected to higher burden of illness and poorer treatment response, and not only in disorders with high levels of dissociation. This meta-analysis offers a systematic and evidence-based study of the prevalence and distribution of dissociation, as assessed by the Dissociative Experiences Scale, within different categories of mental disorders, and it updates an earlier meta-analysis.Method:More than 1,900 original publications were screened, and 216 were included in the meta-analysis, comprising 15,219 individuals in 19 diagnostic categories.Results:The largest mean dissociation scores were found in dissociative disorders (mean scores >35), followed by posttraumatic stress disorder, borderline personality disorder, and conversion disorder (mean scores >25). Somatic symptom disorder, substance-related and addictive disorders, feeding and eating dis...

Prevention of Mental Health Disorders Using Internet- and Mobile-Based Interventions: A Narrative Review and Recommendations for Future Research.

Abstract: Although psychological interventions might have a tremendous potential for the prevention of mental health disorders (MHD), their current impact on the reduction of disease burden is questionable. Limitations of traditional prevention programs could potentially be overcome by providing Internet- and mobile-based interventions (IMIs). This article provides an introduction to the subject, discusses areas of application, and narratively reviews the available evidence for the efficacy and cost-effectiveness of IMIs with regard to the prevention of MHD onset. Subsequently we provide recommendations for future research. We identified ten randomized trials of which six found significant effects in favor of the intervention group. With regard to specific disorders, only for the indicated prevention of depression is there consistent evidence (across 4 trials). The only trial on the prevention of general anxiety did not result in positive findings. With regard to the prevention of eating disorders, positive effects were only found in post-hoc subgroup analyses, indicating that it might be possible to prevent eating disorder onset for specific subpopulations of people at risk of developing eating disorders. Only one study evaluated the cost-effectiveness of an IMI and found that an indicated intervention for the prevention of depression had a high likelihood for providing good value for the money spent. Disorders not examined so far include for example substance use, psychotic-, bipolar-, stress-related-, phobic- and panic-, obsessive-compulsive-, impulse-control-, somatic symptom disorder and insomnia. No published study so far has evaluated the effect of a mobile only preventive intervention on disorder onset or made use of phone- or wearable sensors. In summary, available evidence clearly indicates the huge potential of IMIs for the prevention of MHD.However, there is a need for more rigorously conducted large scale randomized controlled trials. Future directions for the field are discussed that seem necessary in order to fully exploit the potential of IMI for the prevention of MHD. Among others these are the need to evaluate m-health interventions, the cost-effectiveness of IMIs; interventions in children and adolescents; the role of human support in preventive interventions; possible adverse effects of MHD prevention IMIs; and strategies to increase utilization of available interventions.