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Somatoform Disorders

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Research articles:

Chioqueta, A. P., & Stiles, T. C. (2004). Suicide risk in patients with somatization disorder. Crisis, 25, 3-7. doi:10.1027/0227-5910.25.1.3

The aim of the study was to assess suicide risk in psychiatric outpatients with and without Somatization disorder. A total sample of 120 psychiatric outpatients was used in the study, 29 of whom met diagnostic criteria for Somatization disorder. The results indicated that Somatization disorder was significantly associated with suicide attempts even when the effects of both a comorbid major depressive disorder and a comorbid personality disorder were statistically controlled for. The results suggest that, although a patient meets the criteria for a principal diagnosis of major depressive disorder and/or a personality disorder, it is still of significant importance to decide whether or not the patient also meets the criteria for a Somatization disorder in order to more optimally assess suicide risk. The findings highlight the fact that the potential for suicide in patients with Somatization disorder should not be overlooked when a diagnosable depressive disorder or personality disorder is not present. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (from the journal abstract)

Didie, E. R., Kelly, M. M., & Phillips, K. A. (2010). Clinical features of body dysmorphic disorder. Psychiatric Annals, 40(7), 310-316. doi:10.3928/00485713-20100701-03

Body dysmorphic disorder (BDD) is a relatively common, often severe disorder that has been described for more than a century. During this time, numerous case reports have emerged from around the world. BDD consists of a distressing or impairing preoccupation with an imagined or slight defect in appearance; if a slight physical anomaly is present, the person's concern is markedly excessive. BDD is a relatively common disorder with a long historical tradition. During the past several decades, systematic research has elucidated its clinical features, which includes very poor psychosocial functioning and quality of life. Suicide rates appear markedly high. However, there are only limited data on some important aspects of BDD, including suicidality, BDD's expression in children and adolescents, clinical features of BDD in other cultures, and course of illness. It is hoped that future research on BDD will shed light on aspects of this disorder that remain poorly understood, which in turn is expected to improve the detection and treatment of this often-severe disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Morrison, J. (1989). Increased suicide attempts in women with somatization disorder. Annals of Clinical Psychiatry, 1(4), 251-254. doi:10.3109/10401238909149991

Reviews data from studies of suicide attempts among women with somatization disorder, including studies by J. Purtell et al (1951), M. Perley and S. Guze (1962), and J. Morrison and J. Herbstein (see record 1989-12024-001). In 2 generations, suicide attempts in females with somatization disorder have increased from nearly 0% to 50% in a series of 60 patients diagnosed using Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria. 95% also qualified for diagnoses of Briquet's syndrome. There has been no comparable increase in women with primary affective disorder. Psychiatric diagnoses related to personality disorder may account for much of the recently noted rise in reported suicide attempts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Phillips, K. (2007). Suicidality in body dysmorphic disorder. Primary Psychiatry, 14(12), 58-66. Retrieved from EBSCOhost.

Suicidal ideation, suicide attempts, and completed suicide appear common in individuals with body dysmorphic disorder (BDD). Available evidence indicates that approximately 80% of individuals with BDD experience lifetime suicidal ideation and 24% to 28% have attempted suicide. Although data on completed suicide are limited and preliminary, the suicide rate appears markedly high. These findings underscore the importance of recognizing and effectively treating BDD. However, BDD is underrecognized in clinical settings even though it is relatively common and often presents to psychiatrists and other mental health practitioners, dermatologists, surgeons, and other physicians. This article reviews available evidence on suicidality in BDD and discusses how to recognize and diagnose this often secret disorder. Efficacious treatments for BDD, ie, serotonin reuptake inhibitors (SRls) and cognitive-behavioral therapy, are also discussed. Although data are limited, it appears that SRIs often diminish suicidality in these patients. Additional research is greatly needed on suicidality rates, characteristics, correlates, risk factors, treatment, and prevention of suicidality in BDD.

Tomasson, K., Kent, D., & Coryell, W. (1991). Somatization and conversion disorders: Comorbidity and demographics at presentation. Acta Psychiatrica Scandinavica, 84(3), 288-293. Retrieved from EBSCOhost.

Although somatization disorder and conversion disorder are linked in DSM-III and DSM-III-R, they have very different histories. To directly compare these disorders, we reviewed the records accrued for 2 years at a large medical center and identified 65 somatization disorder patients and 51 conversion disorder patients. They differed substantially. The large majority (78%) of conversion disorder patients and nearly all (95%) of the somatization disorder patients were women. Ages at onset occurred throughout the life span among conversion disorder patients but mostly before the age of 21 among the somatization disorder patients. Somatization disorder patients were more likely to have had a history of depression, attempted suicide, panic disorder and divorce.

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