Studies On Characters And Related Factors Of Somatization Disorder

ObjectiveTo investigate the relationship between somatization disorder and depression from various aspects of research, such as demography, clinical feature, psychology and cognitive function in China.Methods1. 72 patients with somatization disorder and 84 depression patients enrolled during a same period were investigated with self-design questionnaires of demography and complaint symptoms and Hamilton depression rating scale(HAMD). ICD-10 and CCMD-3 diagnostic criteria were assigned by consensus after the interviews were evaluated by three independent psychiatric doctors.2.Symptom Checklist-90(SCL-90), Eysenck's Personality Questionnaire(EPQ), Tornto Alexithymia Scale(TAS-20) , Trait Coping Style Questionnaire(TCSQ),Social Supporting Rating Scale( SSRS)were administered to 56 patients with somatization disorder and 56 age-, sex-education-matched depression patients.3. 52 patients with somatization disorder and 54 age-, sex-, education-matched depression patients, who were above primary school education and right handedness, were tested with Cognitive AbilitiesScreening Instrument(CASI) .Results1. The onset age of somatization disorder group was obvious earlier than that of depression group. The constituent ratio of rural population in somatization group was higher than that in depression group. The subjective evaluation to family's economic status in somatization group was lower than that in depression group. The course of somatization disorder was longer than that of depression group. The constituent ratio of rural population of denying psychological reasons in patients with somatization disorder was lower than that in depression patients. The percentage of depression family history in patients with somatization disorder was lower than that in depression patients. All the difference had significant(P<0.05 or P<0.01).2. The systems involved in and total number of complaints in patients with somatization disorder were obvious higher than those in depression patients(P<0.01). The order of complains in patients with somatization disorder was stomach discomfort(10.8%), aches of muscle and articulus(10.4%), skin discomfort(9.9%); while in depression patients was sleep disorder(13.7%), hypodynamia (13.4%), anepithymia and athrepsy(12.1%), the difference were significant(P<0.05).3. The total score of HAMD in patients with somatization disorder was obvious lower than that in depression group(P<0.05). The scores of anxiety/somatization factor and body weight, cognitive handicap hysteresis in patients with somatization disorder was obvious higher or lower than those in depression group respectively(P<0.01).4. Compared with depression group, the scores of total SCL-90, somatization, obsess-compulsion and paranoid factor was obvious higher and interpersonal relationship, depression, phobia and sypchosis factor were lower in patients with somatization disorder, there were significant difference(P<0.05).There were significant difference in EPQ, TAS-20, SSRS and TCSQ between somatization disorder and depression group(P<0.01). The total score and scores of attention, mental arithmetic, new memory and old memory were higher and the scores of language and concept judgement were lower in somatization disorder group than in depression group(P<0.05).ConclusionsSomatization disorder is difference with depression in social demography, clinical trait, psychology and cognition. Somatization is an independent disease. ObjectiveTo explore the clinical characteristic and related factors in patients with somatization disorder on demography, clinical characteristic, psychology and cognitive function. In order to provide some guidance to recognize and diagnose somatization disorder, and provide some theoretical basis for the early prevention and mental intervention of somatization disorder.Methods1. Self-design questionnaires of demography and complaint symptoms were administered to investigate the demography and clinical characteristic of somatization disorder.2. 56 somatization disorder patients and 50 normal controllers took psychological assessment, including SCL-90, EPQ, TAS-20, TCSQ, Life Event Scale(LES), Egma minnen av bardndosnauppforstan(EMBU).3. Wechsler Adult Intelligence Scale(WAIS-RC), Wisconsin Card Sorting Test(WCST), Verbal Fluency task(VFT), attention-canceling test and event-related potentials -P300 test were used to study the cognitive function.4. Sympathetic skin response(SSR) was administered to understand the autonomic nerve function.Results1. The demography characteristic of somatization showed that female patients were more than male ones significantly, the ratio was 1:1.7. Ural patients were more than urban ones, there were significant difference(P<0.01). The patients were main middle-education(45.8%) and physical workers(72.9%). Subjective evaluation of family economic status was middle level(57.7%).2. The clinical feather of somatization disorder showed that its course was 8.12±7.19 years on average, majority patients denied mental motivation, they were main slow-moving onset. The number of symptoms and involved systems was 8.50±1.47 and 4.51±0.87 on average respectively. The symptom of skeletal musculature system, digestive system and nervous system was 72.9%, 71.2% and 62.7% respectively.3. The total score and each factor's scores of SCL-90 except hostility factor in somatization disorder group were obvious higher than those in control group(P<0.01 or P<0.05). The scores of EPQ-E, EPQ-N, EPQ-L and F1, F2, F3 and total score of TAS-20 in somatization disorder group were obvious higher than those in control group(P<0.01 or P<0.05). The scores of parental warmth and understanding factor and the mother's over-intervention and overprotection factor in somatization disorder group were obvious lower than those in control group(P<0.05). Compared with control group, the total score and the scores of negative, family and social intercourse life event in somatization disorder group were obvious higher, the total score and subjective social supporting were lower. The scores of negative and positive coping style in somatization disorder group were higher and lower than those in control group respectively(P<0.01).4. The style of onset, family economic status, course of disease, the number of symptoms and onset had forecasting meaning for somatization disorder. The psychological risk factors of somatization disorder were neurotic personality, TAS-F1, TAS-F2, more negative and family life events, less subjective social supporting , more negative coping style and less mother's warmth and more father's over-intervention.5. The results of cognitive function showed(1) Compared with control group, the patients with somatization disorder had lower scores of comprehension, numeral scope, words, encoding, completion of drawing and pictures arrange (P<0.05), had more total test number and persist error number of WCST, had less total VFT and attention-canceling test and more repeat number of VFT and leakage number of attention-canceling test. There were significant difference(P<0.05). The latency of N2 and P3 of P300 were longer and the amplitude of N2 and P3 of P300 lower in somatization disorder group than in normal control group(P<0.01).(2) The course of disease of somatization disorder was positive correlation with latency of P2, P3, and negative correlation with N2, P2 and P3. The number of symptoms in somatization disorder group was positive correlation with the latency of N2 and P3, negative correlation with N1 and P3. The latency of N2,P3 were positive correlation with the total score and somatization factor of SCL-90, the amplitude of P3 was negative correlation with the total score and somatization factor, the latency of N1 and P2 were positive correlation with somatization factor and total score respectively, the amplitude of N2 was negative with total score . All of them had significant difference(P<0.05 or P<0.01).6. Compared with control group, the latency and amplitude of SSR in somatization disorder group prolonged and decreased respectively(P<0.05). The latency of SSR was negative somatization factor of SCL-90, the amplitude of SSR was negative correlation with the course and number of symptoms and positive correlation with total score of SCL-90(P<0.01). The latency of SSR was positive correlation with the serous degree of symptoms of digestive system, respiration and circulation system, skin and genitourinary system. The amplitude of SSR was negative correlation with the serous degree of symptoms of nervous system, respiration and circulation system, skin and genitourinary system(P<0.05 or P<0.01). Conclusions1 The characteristics of somatization disorder shows as following:1.1 The female patients are more, and majority patients are poor social and economic status.1.2 Onset of the disease is slow, the course is long and persisting.1.3 The symptoms of somatization disorder are more, and the systems involved are wide. Majority patients deny social psychological causes.1.4 Somatization disorder patients have nervousness and extraversion personality trait and alexithymia.1.5 The patients with somatization disorder have cognitive functional disturbance and dysautonomia. P300 and SSR have certain reference value to diagnose somatization disorder.2 The parental rearing style, negative life events especially family life event, poor social supporting and negative coping style are related with development of somatization disorder.