Distinct associations of DSM-5 Somatic Symptom Disorder, the Diagnostic Criteria for Psychosomatic Research-Revised (DCPR-R) and symptom severity in patients with irritable bowel syndrome.
Gen Hosp Psychiatry
; 64: 56-62, 2020.
Article
en En
| MEDLINE
| ID: mdl-32199282
OBJECTIVE: The clinical management of high symptom severity is a challenging task with patients with functional somatic disorders. We investigated the extent to which DCPR-revised (DCPR-R) syndromes and the DSM-5 category of Somatic Symptom Disorder (SSD) were able to predict symptom severity in 203 consecutive tertiary care patients with irritable bowel syndrome (IBS). METHOD: Semistructured interview were used for assessing DCPR-R and validated scales for SSD (combining PHQ-12 and WI-7), severity of symptoms (IBS-SSS), psychological distress (HADS), and psychosocial functioning (SF-12). RESULTS: Compared to moderate severity (IBS-SSS = 175-300), patients in the high range of severity (IBS-SSS > 300) had significantly more DCPR-R syndromes (particularly alexithymia and persistent somatization), higher psychological distress, and poorer psychosocial functioning, but showed no difference for SSD. DCPR-R, particularly alexithymia and persistent somatization, significantly and independently predicted IBS severity by explaining 18.5% of the IBS-SSS variance with large effect size (d = 1.18), after controlling for covariables. Conversely, SSD was not able to significantly predict IBS severity. CONCLUSIONS: This study highlights the need of an integrative approach in the medical setting. Psychosomatic factors play a relevant role in the individual perception of symptom severity and should be carefully evaluated for clinical management of functional syndromes.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trastornos Psicofisiológicos
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Trastornos Somatomorfos
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Síntomas Afectivos
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Síndrome del Colon Irritable
Tipo de estudio:
Diagnostic_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Gen Hosp Psychiatry
Año:
2020
Tipo del documento:
Article
Pais de publicación:
Estados Unidos