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Arch Gen Psychiatry. 1997 Apr;54(4):352-8.

Multisomatoform disorder. An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care.

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  • 1Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md, USA.

Abstract

BACKGROUND:

For clinical or research use in primary care, the DSM-IV diagnostic criteria for somatization disorder are too restrictive, while the criteria for undifferentiated somatoform disorder are overly inclusive. In this article, we examine the validity of multisomatoform disorder, defined as 3 or more medically unexplained, currently bothersome physical symptoms plus a long (> or = 2 years) history of somatization.

METHODS:

Data from the Primary Care Evaluation of Mental Disorders Study of 1000 patients from 4 primary care sites were analyzed. The outcomes assessed were 6 domains of health-related quality of life, using the 20-item Short-Form General Health Survey; self-reported disability days and health care use; satisfaction with care; and physician-rated difficulty of the encounter.

RESULTS:

Multisomatoform disorder was diagnosed in 82 (8.2%) of the 1000 patients who were enrolled in the Primary Care Evaluation of Mental Disorders Study. Compared with mood and anxiety disorders, multisomatoform disorder was associated with comparable impairment in health-related quality of life, more self-reported disability days and clinic visits, and greater clinician-perceived patient difficulty.

CONCLUSIONS:

Multisomatoform disorder may be a valid diagnosis and potentially more useful than the DSM-IV diagnosis of undifferentiated somatoform disorder. Also, because multisomatoform disorder has a large and independent effect on impairment, its diagnosis should not be precluded simply because of a coexisting mood or anxiety disorder.

Comment in

  • Multisomatoform disorder. [Arch Gen Psychiatry. 1998]
PMID:
9107152
[PubMed - indexed for MEDLINE]
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