Medical costs of somatoform inpatients. The relationship between symptomatic distress, presence of personality disorders, traumatic life experiences, and medical costs in a psychosomatic population at Eikenboom, centre for psychosomatic medicine.

Abstract

Context: Somatoform disorders are an important determinant of medical care utilization, but their independent effect on utilization is difficult to determine because somatizing patients frequently have psychiatric and medical comorbidity. Objective: The assessment of the extent of symptomatic distress; the overlap of somatoform disorder with personality disorders; the overlap of somatoform disorder with traumatic experiences; and the relation between symptomatic distress, personality disorders, trauma, and medical costs in a population with somatoform disorders. Method: Patients (74 females, 25 males) of a tertiary referral clinic for psychosomatic medicine were surveyed with an interview and self-report questionnaires assessing symptomatic distress (SCL-90), personality disorder (SCID-II), trauma (VBE), and medical costs of the last four weeks before entering the clinic (TiC-P). A hypothesis testing research design was applied. Results: Significant positive correlations were found between symptomatic distress and medical costs, and between physical trauma and medical costs. Non-significant positive relations were found between emotional trauma and medical costs, and sexual trauma and medical costs. Personality disorders were found not be positively correlated with medical costs. Discussion/Conclusion: Regarding the results of the present study, one may conclude that evidence was found for the relationship between symptomatic distress, trauma, and medical costs in a psychosomatic population, supporting previous research. Overall, one may conclude that further research, taking the limitations of the present study into account, is necessary, as nearly all of the somatoform disorder patients in this study report -frequent- use of health care recourses with costs leading up to 3500 Euro’s a month. Further research might enhance the understanding of somatoform disorders, causal factors, and medical costs, which then might have implications for treatment of somatoform disorders.