Functional Impairment and Somatoform Disorders
Stadt, M.H.A. van der
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Objective: The purpose of this study was to examine certain precipitating, predisposing and perpetuating factors in functional impairments in a Somatoform population. A special emphasize was made on Somatisation Disorder, abuse and symptom-report, as it is expected that these factors have important contributions for functional impairment. Methods: 42 patients (age between 21-59) of inpatient somatoform psychiatric hospital ‘Eikenboom’ in the Netherlands completed the following questionnaires: SF-36, SCL-90, VBE. A SCID was administered to determine psychiatric diagnosis. 8 patients were diagnosed with a Somatisation Disorder, 16 with a Pain Disorder, 10 with an Undifferentiated Somatoform Disorder. Results: Somatisation Disorder showed in comparison with Pain Disorder and Undifferentiated Somatoform Disorder significantly more impairment in Social Functioning. Somatisation Disorder showed in comparison with Pain Disorder significantly more impairment in Vitality. Somatisation Disordered patients’ Vitality was influenced by their symptom-report. Physical impairment was further equal across groups. Experiencing a combination of sexual, physical and sexual abuse was associated with significantly worse General Health when compared to emotional abuse. There were no other significant differences between different types of abuse in mental and physical impairment. Conclusion: The results encourage further examination of the role of maladaptive illness behaviors in functional impairment in somatoform patients, as this study offered some evidence for this association. While the current study is one of an explorative character, more research is necessary to determine more specific risk factors associated with functional impairment in a Somatoform population.