Assessing somatization in urologic chronic pelvic pain syndrome

BACKGROUND: This study examined the prevalence of somatization disorder in Urological Chronic Pelvic Pain Syndrome (UCPPS) and the utility of two self-report symptom screening tools for assessment of somatization in patients with UCPPS. METHODS: The study sample included 65 patients with UCPPS who enrolled in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Study at Washington University. Patients completed the PolySymptomatic PolySyndromic Questionnaire (PSPS-Q) (n = 64) and the Patient Health Questionnaire-15 Somatic Symptom Severity Scale (PHQ-15) (n = 50). Review of patient medical records found that only 47% (n = 30) contained sufficient documentation to assess Perley-Guze criteria for somatization disorder. RESULTS: Few (only 6.5%) of the UCPPS sample met Perley-Guze criteria for definite somatization disorder. Perley-Guze somatization disorder was predicted by definite PSPS-Q somatization with at least 75% sensitivity and specificity. Perley-Guze somatization disorder was predicted by severe (\u3e 15) PHQ-15 threshold that had \u3e 90% sensitivity and specificity but was met by only 16% of patients. The moderate (\u3e 10) PHQ-15 threshold had higher sensitivity (100%) but lower specificity (52%) and was met by 52% of the sample. CONCLUSIONS: The PHQ-15 is brief, but it measures symptoms constituting only one dimension of somatization. The PSPS-Q uniquely captures two conceptual dimensions inherent in the definition of somatization disorder, both number of symptoms and symptom distribution across multiple organ systems, with relevance for UCPPS as a syndrome that is not just a collection of urological symptoms but a broader syndrome with symptoms extending beyond the urological system

The distinction of 'Psychosomatogenic family types' Based on parents' self reported questionnaire information: a cluster analysis

The theory of 'psychosomatogenic family types' is often used in treatment of somatizing adolescents. This study investigated the validity of distinguishing 'psychosomatogenic family types' based on parents' self-reported family features. The study included a Flemish general population sample of 12-year olds (n = 1428). We performed cluster analysis on 3 variables concerning parents' self-reported problems in family functioning. The distinguished clusters were examined for differences in marital problems, parental emotional problems, professional help for family members, demographics, and adolescents' somatization. Results showed the existence of 5 family types: 'chaotic family functioning,' 'average amount of family functioning problems,' 'few family functioning problems,' 'high amount of support and communication problems,' and ' high amount of sense of security problems' clusters. Membership of the 'chaotic family functioning' and 'average amount of family functioning problems' cluster was significantly associated with higher levels of somatization, compared with 'few family functioning problems' cluster membership. Among additional variables, only marital and parental emotional problems distinguished somatization relevant from non relevant clusters: parents in 'average amount of family functioning problems' and 'chaotic family functioning' clusters reported higher problems. The data showed that 'apparently perfect' or 'enmeshed' patterns of family functioning may not be assessed by means of parent report as adopted in this study. In addition, not only adolescents from 'extreme' types of family functioning may suffer from somatization. Further, professionals should be careful assuming that families in which parents report average to high amounts of family functioning problems also show different demographic characteristics

An exploratory study on internet addiction, somatic symptoms and emotional and behavioral functioning in school-aged adolescents

Objective: In the last two decades there has been a significant transformation regarding the use of new technologies. Despite growing acknowledgement concerning the different activities and functions of digital technologies, there remains a lack of understanding on how technology overuse may negatively impact both physical and psychosocial well-being. Although researchers have begun to explore the meaning and implications of excessive Internet use in non-clinical populations of children and adolescents, there is still little consistent knowledge on the topic. This study aimed to extend existing knowledge on the excessive use of the Internet among school-aged adolescents, focusing on its association with recurrent somatic symptoms, depressive risk and behavioral and emotional problems. Method: Two hundred and forty adolescents (51.9% females) aged between 10 and 15, participated in this study. Data was collected using the Children’s Somatization Inventory, the Internet Addiction Test, the Children’s Depression Inventory, the Youth Self Report and the Emotion Regulation Questionnaire. Structural Equation Model analysis was used to analyse the data. Results: Approximately 21.8% of participants reported excessive Internet use based on Young’s criteria. Higher levels of Internet use were associated with somatic and depressive symptoms as well as emotional and behavioral problems. Depressive Symptoms predicted both Internet Addiction (b = 0.304, p < 0.001) and Internalizing (b = 0.542, p <0.001) and Externalizing problems (b = 0.484, p < 0.001). Internet Addiction also significantly predicted both Internalizing (b = 0.162, p = 0.02) and Externalizing problems (b = 0.183, p = 0.02). Finally, Structural Equation Modeling showed that the indirect effect of Depressive Symptoms (via Internet Addiction) on Internalizing or Externalizing problems were significant. Conclusions: Longitudinal studies are needed to confirm these findings and to identify the mechanisms linking Internet use, somatic symptoms and adaptive functioning

Somatization vs. Psychologization of Emotional Distress: A Paradigmatic Example for Cultural Psychopathology

This paper describes the developing area of cultural psychopathology, an interdisciplinary field of study focusing on the ways in which cultural factors contribute to the experience and expression of psychological distress. We begin by outlining two approaches, often competing, in order to provide a background to some of the issues that complicate the field. The main section of the paper is devoted to a discussion of depression in Chinese culture as an example of the types of questions that can be studied. Here, we start with a review of the epidemiological literature, suggesting low rates of depression in China, and move to the most commonly cited explanation, namely that Chinese individuals with depression present this distress in a physical way. Different explanations of this phenomenon, known as somatization, are explored and reconceptualized according to an increasingly important model for cross-cultural psychologists: the cultural constitution of the self. We close by discussing some of the contributions, both theoretical and methodological, that can be made by cross-cultural psychologists to researchers in cultural psychopathology

An Exploratory Study on the Influence of Psychopathological Risk and Impulsivity on BMI and Perceived Quality of Life in Obese Patients

The present study aimed to assess the psychological profiles of adult male and female obese patients, as well as to verify the possible influence of their psychopathological risk and impulsivity on their body mass index (BMI) and perceived quality of life. A total of 64 obese subjects accessing a center for care of their obesity were assessed through anthropometric and psychometric measurements. All anthropometric measures in men were higher than in women, while in turn, women showed higher psychopathological symptoms. Furthermore, the symptoms of somatization and psychoticism were predictors for a higher BMI in men, but there was no effect of psychopathological symptoms on the perceived quality of life (QoL) of male subjects. Moreover, in women, somatization and attentional impulsivity were predictors for a higher BMI, whereas no correlation was found between their psychopathological risk and perceived QoL. The results of regression analysis underlined that somatization is a “core” psychopathological symptom in obese subjects regardless of their sex, which is a potential predictor for a higher BMI. The psychological difficulties of the subjects had no effect on their perceived QoL, suggesting that they find it difficult to reflect on the impact that obesity has on their life

Predictors of course and outcome in hypochondriasis after cognitive-behavioral treatment

Background. Predictors of treatment outcome were evaluated in a clinical sample suffering from hypochondriasis. Methods: The sample consisted of 96 patients with hypochondriacal disorder according to DSM-IV or high syndrome scores on the Illness Attitude Scales (IAS) or Whiteley Index (WI). After intense inpatient cognitive-behavioral treatment (CBT), 60% of the patients were classified as responders because of substantial improvements or recovery from hypochondriacal symptomatology. Results: Non-responders were characterized by a higher degree of pre-treatment hypochondriasis, more somatization symptoms and general psychopathology (SCL-90R), more dysfunctional cognitions related to bodily functioning, higher levels of psychosocial impairments, and more utilization of the health care system as indicated by the number of hospital days and costs for inpatient treatments and medication. No predictive value was found for sociodemographic variables, comorbidity with other mental disorders and chronicity. Multiple linear regression showed that pre-treatment variables significantly predicted IAS scores at post-treatment (R-2 = 0.59), changes during treatment (0.10), IAS scores at follow-up two years later (0.41) and changes between baseline and follow-up (0.25). Conclusions: The results demonstrate the relevance of various psychopathological variables and health care utilization as important indicators for outcome and further course of clinical hypochondriasis. Copyright (C) 2002 S. Karger AG, Basel

Somatisation in primary care: A comparative study of Australians, Latin Americans, Vietnamese, and Polish living in Australia

This study identified differences in somatisation symptoms, psychiatric status, and the relationship between acculturation and somatisation. It also investigated GP’s (general practitioners) ability to detect somatisation in primary healthcare setting. A survey was carried out on 207 patients from Australia, Latin America, Vietnam, and Poland. A demographic questionnaire, an acculturation questionnaire, the Somatization Scale of the Symptom Checklist-90-Revised (SCL-90-R), the Self-Reporting Questionnaire (SRQ), and the Illness Behaviour Questionnaire (IBQ) were administered in the participants’ respective languages. In addition, GPs completed a brief rating scale with findings from medical consultation. These results demonstrated that psychosocial status was highly correlated to somatisation for Australians, Latin Americans, Vietnamese, and Polish. Overall, however, these groups did not present significant differences in symptoms of somatisation. GPs were generally inaccurate in detecting psychosocial difficulties and acculturation did not predict levels of somatisation in the three ethnic groups

Attachment relationships and internalization and externalization problems in a group of adolescents with pathological gambling disorder

Objective: The evidence accumulated in the relevant literature suggests that the presence and evolution of gambling could be correlated with the internalizing and externalizing problems and with the attachment style. This paper aims at exploring this perspective further. In particular, it analyses how such risk factors interact within the specific context of adolescent gambling disorder. Method: The sample comprises 91 adolescents, 61 male and 30 female, in the 17-22 age range (M = 17.77; SD = 0.98). A structural equation model was used to examine the relationship between the Youth Self-Report latent factors and pathological gambling, and the mode of attachment was assumed to act as a moderator. Results: Our results suggest that in the group characterized by a fearful attachment style there was a positive relationship between somatization and propensity to risk (p = 0.008), whereas in the dismissing attachment group there was a positive relationship between a greater tendency to delinquent behaviour and gambling risk (p = 0.042). Conclusions: The various insecure attachment stylespatterns may contribute in different ways to the development of oppositional-provocative behaviour and problems of conduct in adolescents