Article

The Relationship Between Somatic Symptoms, Health Anxiety, and Outcome in Medical Out-Patients

School of Community Based Medicine, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK.
The Psychiatric clinics of North America (Impact Factor: 1.87). 09/2011; 34(3):545-64. DOI: 10.1016/j.psc.2011.05.001
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ABSTRACT The author and colleagues tested cut point scores on measures of total somatic symptoms and health anxiety of new medical out-patients, to determine whether they predicted health status and number of medical consultations. High-scoring participants had significantly more impaired health status and medical consultations. High scores were associated with dissatisfaction with the doctor's explanation of their symptoms. Whether symptoms were medically explained or not made little difference to these results; anxiety and depression were not found to have effect. The author and colleagues found support for the combination of somatic symptoms and health anxiety as proposed in DSM-V complex somatic symptom disorder.

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    • "As was suggested by the APA [5], we employed the Whiteley-Index [WI; 28] to measure criterion B and, therefore, the degree of health anxiety and health concerns. Although Creed [3] recommended a high threshold for health anxiety in SSD (two fea- tures out of criterion B instead of only one ) , the established cut - off score of 8 for hypochondriasis [ 32 ] appeared , to us , to be too high for the diagnosis of SSD . Since the currently proposed DSM - 5 diagno - ses also include a new diagnosis called illness anxiety disorder which focuses on high health anxiety , and SSD is only suggested to replace the diagnoses with predominant physical symptoms , we decided on the following : As a reasonable cut - off for criterion B , we chose a score of 6 , which was found to be non - specific for hypochondriasis vs . "
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    ABSTRACT: To compare the predictive validity and clinical utility of DSM-IV somatoform disorders and DSM-5 Somatic Symptom Disorder (SSD) at 12-month follow-up. In a sample of psychosomatic inpatients (n=322, mean age=45.6years (SD 10.0), 60.6% females) we prospectively investigated DSM-IV somatoform disorders and the DSM-5 diagnosis of SSD plus a variety of psychological characteristics, somatic symptom severity, and health-related quality of life at admission, discharge, and follow-up. DSM-IV diagnoses and DSM-5 SSD similarly predicted physical functioning at follow-up; SSD also predicted mental functioning at follow-up. Bodily weakness, intolerance of bodily complaints, health habits, and somatic attribution at admission were significant predictors of physical functioning at follow-up. The change in physical functioning during inpatient therapy was a significant predictor for the course of physical functioning until follow-up. Psychological symptoms appear to be predictively valid diagnostic criteria for the 12-month functional outcome in patients with SSD. Mental functioning can be better predicted by the DSM-5 diagnosis than by DSM-IV diagnoses. Not the change in single psychological features but in physical functioning during the treatment interval predicted the change in physical functioning until follow-up.
    Journal of psychosomatic research 10/2013; 75(4):358-361. DOI:10.1016/j.jpsychores.2013.08.017 · 2.84 Impact Factor
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    • "As was suggested by the APA [5], we employed the Whiteley-Index [WI; 28] to measure criterion B and, therefore, the degree of health anxiety and health concerns. Although Creed [3] recommended a high threshold for health anxiety in SSD (two fea- tures out of criterion B instead of only one ) , the established cut - off score of 8 for hypochondriasis [ 32 ] appeared , to us , to be too high for the diagnosis of SSD . Since the currently proposed DSM - 5 diagno - ses also include a new diagnosis called illness anxiety disorder which focuses on high health anxiety , and SSD is only suggested to replace the diagnoses with predominant physical symptoms , we decided on the following : As a reasonable cut - off for criterion B , we chose a score of 6 , which was found to be non - specific for hypochondriasis vs . "
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