MEagenda posted this to co-cure 4 days ago
[if: MEagenda is amazing. In looking over the papers posted here, a number are literature reviews. I'm reminded of Ann Rand - medicine by committee........... Interesting the timing and topics of the articles and the proposed DSM-5 changes. (my bolds and colours)]
From Suzy Chapman
19 March 2010
There is a new MUS Rief paper published in the current (March '10) edition
of the Journal of Psychosomatic Research.
Also In Press papers by White (CFS: One discrete syndrome or many? FSSs);
Knoop, Prins, Moss-Morris, Bleijenberg (Central role of cognitive processes
in the perpetuation of chronic fatigue syndrome); Voigt, Lwe (Systematic
review of somatoform disorder diagnoses and suggestions for future
classification, DSM-5 and proposed new category CSSD, CISSD Project:
Kroenke, Sharpe, Sykes: example criteria); Escobar (3 or more concurrent
somatic symptoms predict psychopathology and service use); Henningsen,
Creed (Screening for multiple somatic complaints); Chalder (Measuring
fatigue).
Journal of Psychosomatic Research's Co-editor, Francis Creed, is a member of the APA's DSM-5 Somatic Symptom Disorder Work Group and had been a member of the CISSD Project.
Journal of Psychosomatic Research
Volume 68, Issue 3, Pages 219-316 (March 2010)
http://www.jpsychores.com/home
http://www.jpsychores.com/current
Current (March 10 issue)
Patients with medically unexplained symptoms and their significant others:
Illness attributions and behaviors as predictors of patient functioning
over time, 10 December 2009
Anja Hilbert, Alexandra Martin, Thomas Zech, Elisabeth Rauh, Winfried Rief
pages 253-262
Abstract | Full Text | Full-Text PDF (161 KB)
http://www.jpsychores.com/article/S0022-3999(09)00375-4/abstract
----------------------
Articles In Press
http://www.jpsychores.com/inpress
Chronic fatigue syndrome: Is it one discrete syndrome or many? Implications
for the "one vs. many" functional somatic syndromes debate
In Press Corrected Proof, Available online 18 March 2010
Peter D. White
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.008
Abstract | Full Text | Full-Text PDF (110 KB)
http://www.jpsychores.com/article/S0022-3999(10)00013-9/abstract
Chronic fatigue syndrome: Is it one discrete syndrome or many? Implications
for the "one vs. many" functional somatic syndromes debate
Peter D. White
Received 10 November 2009; received in revised form 12 January 2010;
accepted 14 January 2010. published online 18 March 2010.
Corrected Proof
Abstract
There is a current debate as to whether "functional somatic syndromes"
(FSSs) are more similar to or different from each other. While at the same
time, there is evidence of heterogeneity within single syndromes. So, it
could be that these syndromes are all part of one big process/illness, are
discrete in their own right, or that they are heterogeneous collections of
different illnesses lumped together by common symptoms but separated by
uncommon pathophysiologies. The example of chronic fatigue syndrome (CFS)
is instructive. There is evidence to support all three models of
understanding. Three recent large studies have suggested that FSSs are both
similar and dissimilar at the same time. The solution to the debate is that
we need to both "lump" and "split." We need to study both the similarities
between syndromes and their dissimilarities to better understand what we
currently call the FSSs.
Keywords: Functional somatic syndromes, Chronic fatigue syndrome,
heterogeneity, homogeneity, risk markers
Wolfson Institute of Preventive Health, Barts and The London School of
Medicine and Dentistry, Queen Mary University of London, London, UK
Department of Psychological Medicine, St Bartholomew's Hospital, London,
EC1A 7BE, UK. Tel.: +44 207 601 8108; fax: +44 207 601 7097.
PII: S0022-3999(10)00013-9
doi:10.1016/j.jpsychores.2010.01.008
2010 Published by Elsevier Inc.
----------------------
Articles in Press
http://www.jpsychores.com/inpress
The central role of cognitive processes in the perpetuation of chronic
fatigue syndrome
In Press Corrected Proof , Available online 17 March 2010
Hans Knoop, Judith B. Prins, Rona Moss-Morris, Gijs Bleijenberg
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.022
Abstract | Full Text | Full-Text PDF (122 KB)
http://www.jpsychores.com/article/S0022-3999(10)00063-2/abstract
The central role of cognitive processes in the perpetuation of chronic
fatigue syndrome
Hans Knoop a, Judith B. Prins b, Rona Moss-Morris c, Gijs Bleijenberg d
Received 8 November 2009; received in revised form 26 January 2010;
accepted 26 January 2010. published online 17 March 2010.
Corrected Proof
Abstract
Objective
Chronic fatigue syndrome (CFS) is considered to be one of the functional
somatic syndromes (FSS). Cognitions and behavior are thought to perpetuate
the symptoms of CFS. Behavioral interventions based on the existing models
of perpetuating factors are quite successful in reducing fatigue and
disabilities. The evidence is reviewed that cognitive processes,
particularly those that determine the perception of fatigue and its effect
on behavior, play a central role in the maintenance of symptoms.
Method
Narrative review.
Results
Findings from treatment studies suggest that cognitive factors mediate the
positive effect of behavioral interventions on fatigue. Increased fitness
or increased physical activity does not seem to mediate the treatment
response. Additional evidence for the role of cognitive processes is found
in studies comparing the subjective beliefs patients have of their
functioning with their actual performance and in neurobiological research.
Conclusion
Three different cognitive processes may play a role in the perpetuation of
CFS symptoms. The first is a general cognitive representation in which
fatigue is perceived as something negative and aversive and CFS is seen as
an illness that is difficult to influence. The second process involved is
the focusing on fatigue. The third element is formed by specific
dysfunctional beliefs about activity and fatigue.
Keywords: Chronic fatigue syndrome, Functional somatic syndromes,
Perpetuating factors, Treatment studies, Cognitive processes, Perception
a Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical
Centre, Nijmegen, The Netherlands
b Department of Medical Psychology, Radboud University Nijmegen Medical
Centre, Nijmegen, The Netherlands
c School of Psychology, University of Southampton, Southampton, United
Kingdom
d Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical
Centre, Nijmegen, The Netherlands
Corresponding author. Expert Centre Chronic Fatigue, Radboud University
Nijmegen Medical Centre, Postbox 9011 , 6500 HB Nijmegen, The Netherlands.
Tel.: +31 24 3610042; fax: +31 24 3610041.
This article was written while the first author was a visiting staff member
of the School of Psychology at the University of Southampton. The working
visit was made possible by a grant of the Dutch MSresearch fund (Stichting
MSresearch).
PII: S0022-3999(10)00063-2
doi:10.1016/j.jpsychores.2010.01.022
2010 Elsevier Inc. All rights reserved.
----------------------
Articles in Press
http://www.jpsychores.com/inpress
Towards positive diagnostic criteria: A systematic review of somatoform
disorder diagnoses and suggestions for future classification
In Press Corrected Proof , Available online 15 March 2010
Katharina Voigt, Annabel Nagel, Bjrn Meyer, Gernot Langs, Christoph
Braukhaus, Bernd Lwe
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.015
Abstract | Full Text | Full-Text PDF (183 KB)
Abstract
http://www.jpsychores.com/article/S0022-3999(10)00020-6/abstract
Towards positive diagnostic criteria: A systematic review of somatoform
disorder diagnoses and suggestions for future classification
Katharina Voigta 1, Annabel Nagel a1, Bjrn Meyer a, Gernot Langs b,
Christoph
Braukhaus b, Bernd Lwe a
Received 1 November 2009; received in revised form 12 January 2010;
accepted 14 January 2010. published online 15 March 2010.
Corrected Proof
Abstract
Objectives
The classification of somatoform disorders is currently being revised in
order to improve its validity for the DSM-V and ICD-11. In this article, we
compare the validity and clinical utility of current and several new
diagnostic proposals of those somatoform disorders that focus on medically
unexplained somatic symptoms.
Methods
We searched the Medline, PsycInfo, and Cochrane databases, as well as
relevant reference lists. We included review papers and original articles
on the subject of somatoform classification in general, subtypes of
validity of the diagnoses, or single diagnostic criteria.
Results
Of all diagnostic proposals, only complex somatic symptom disorder* and the
Conceptual Issues in Somatoform and Similar Disorders (CISSD)**
example criteria reflect all dimensions of current biopsychosocial models
of somatization (construct validity) and go beyond somatic symptom counts
by including psychological and behavioral symptoms that are specific to
somatization (descriptive validity). Predictive validity of most of the
diagnostic proposals has not yet been investigated. However, the number of
somatic symptoms has been found to be a strong predictor of disability.
Some evidence indicates that psychological symptoms can predict disease
course and treatment outcome (e.g., therapeutic modification of
catastrophizing is associated with positive outcome). Lengthy symptom
lists, the requirement of lifetime symptom report (as in abridged
somatization), complicated symptom patterns (as in current somatization
disorder), and imprecise definitions of diagnostic procedures (e.g.,
missing symptom threshold in complex somatic symptom disorder) reduce
clinical utility.
Conclusion
Results from the reviewed studies suggest that, of all current and new
diagnostic suggestions, complex somatic symptom disorder and the CISSD
definition appear to have advantages regarding validity and clinical
utility. The integration of psychological and behavioral criteria could
enhance construct and descriptive validity, and confers prospectively
relevant treatment implications. The incorporation of a dimensional
approach that reflects both somatic and psychological symptom severity also
has the potential to improve predictive validity and clinical utility.
Keywords: Classification, Diagnosis, Diagnostic and Statistical Manual of
Mental Disorders, International Classification of Diseases, Somatoform
disorders, Validation studies as topic
a Department of Psychosomatic Medicine and Psychotherapy, University
Medical Center Hamburg-Eppendorf and Schn Klinik Hamburg-Eilbek, Hamburg,
Germany
b Medical and Psychosomatic Hospital Bad Bramstedt, Bad Bramstedt, Germany
Corresponding author. Department of Psychosomatic Medicine and
Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52,
20246 Hamburg, Germany. Tel.: +49 40 7410 59733; fax: +49 40 7410 54975.
1 Both authors contributed equally to this paper.
PII: S0022-3999(10)00020-6
doi:10.1016/j.jpsychores.2010.01.015
2010 Elsevier Inc. All rights reserved.
----------------------
Articles in Press
http://www.jpsychores.com/inpress
Whether medically unexplained or not, three or more concurrent somatic
symptoms predict psychopathology and service use in community populations
In Press Corrected Proof , Available online 17 February 2010
Javier I. Escobar, Benjamin Cook, Chi-Nan Chen, Michael A. Gara, Margarita
Alegra, Alejandro Interian, Esperanza Diaz
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.001
http://www.jpsychores.com/article/S0022-3999(10)00006-1/abstract
Whether medically unexplained or not, three or more concurrent somatic
symptoms predict psychopathology and service use in community populations
Javier I. Escobar, MD ab, Benjamin Cook, PhD c, Chi-Nan Chen, PhD c,
Michael A. Gara, PhD abd, Margarita Alegra, PhD c, Alejandro Interian, PhD
ab, Esperanza Diaz, MD e
Received 6 May 2009; received in revised form 20 December 2009; accepted 5
January 2010. published online 17 February 2010.
Corrected Proof
Abstract
Objectives
To examine the frequency of somatic symptoms in a community population of
various ethnic backgrounds and to identify correlates of these symptoms
such as psychopathology, use of services, and personal distress.
Methods
Using a 14-symptom inventory with interviewer probes for somatic symptoms,
we determined the presence of general physical symptoms (GPS) in a sample
of 4864 white, Latino, and Asian US community respondents. Medically
"edited" verbatim interview responses were used to decide whether or not
physical symptoms would qualify as medically unexplained physical symptoms
(MUPS). We then assessed the association between GPS and MUPS and
psychiatric disorders, psychological distress, and use of services, in both
unadjusted and multivariate regression analyses.
Results
One-third (33.6%) of the respondents reported at least one GPS and 11.1%
reported at least one MUPS within the last year. 10.7% of respondents had
three or more GPS and 1.5% had three or more MUPS. Three or more GPS and
MUPS were positively associated with depressive, anxiety, and substance use
disorders; service use; and psychological distress in unadjusted
comparisons. In multivariate regressions, GPS persisted as a significant
predictor, but there was no significant independent effect of MUPS, after
controlling for GPS and other covariates.
Conclusions
Regardless of the presence or absence of medical explanations, physical
symptoms are an important component of common mental disorders such as
depression and anxiety and predict service use in community populations.
These results suggest that three or more current GPS can be used to
designate a "case" and that detailed probes and procedures aimed at
determining whether or not physical symptoms are medically unexplained may
not be necessary for classification purposes.
Keywords: Somatoform disorders, Epidemiology
a Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, New
Brunswick, NJ, USA
b Department of Family Medicine, UMDNJ-Robert Wood Johnson Medical School,
New Brunswick, NJ, USA
c Center for Multicultural Health Research, Cambridge Health
Alliance-Harvard Medical School, Somerville, MA, USA
d UMDNJ-University Behavioral Health Care (UBHC) Piscataway, NJ, USA
e Department of Psychiatry, Yale University School of Medicine, New Haven
CT, USA
Corresponding author.
PII: S0022-3999(10)00006-1
doi:10.1016/j.jpsychores.2010.01.001
2010 Published by Elsevier Inc.
----------------------
Articles in Press
http://www.jpsychores.com/inpress
Screening for multiple somatic complaints in a population-based survey:
Does excessive symptom reporting capture the concept of somatic symptom
disorders? Findings from the MONICA-KORA Cohort Study
In Press Corrected Proof , Available online 02 March 2010
Karl Heinz Ladwig, Birgitt Marten-Mittag, Maria Elena Lacruz, Peter
Henningsen, Francis Creed, for the MONICA KORA Investigators
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.009
Abstract | Full Text | Full-Text PDF (544 KB)
http://www.jpsychores.com/article/S0022-3999(10)00014-0/abstract
----------------------
Articles in Press
http://www.jpsychores.com/inpress
Measuring fatigue in clinical and community settings
In Press Corrected Proof , Available online 11 December 2009
Matteo Cella, Trudie Chalder
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2009.10.007
Abstract | Full Text | Full-Text PDF (135 KB)
http://www.jpsychores.com/article/S0022-3999(09)00417-6/abstract
-----------------------------------------------------------------------------
Related material:
*The DSM-5 proposal is that Somatoform Disorders, Psychological Factors
Affecting Medical Condition (PFAMC), and Factitious Disorders should be
combined under a common rubric entitled "Somatic Symptom Disorders" and for
a new classification "Complex Somatic Symptom Disorder (CSSD)."
The DSM-5 public review period runs from 10 February to 20 April.
Members of the public, patient representation organisations, professionals
and other end users can submit responses, online.
Please take this opportunity to comment and to alert and encourage
professionals and international patient organisations to participate.
Proposed Draft Revisions to DSM Disorders and Criteria are published here
on the APA's relaunched DSM5.org website:
http://www.dsm5.org/Pages/Default.aspx
Somatoform Disorders:
http://www.dsm5.org/ProposedRevisions/Pages/SomatoformDisorders.aspx
Proposed new DSM-5 category: Complex Somatic Symptom Disorder
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=368
Two Key PDF documents are associated with proposals:
PDF A] Somatic Symptom Disorders Introduction DRAFT 1/29/10
http://www.dsm5.org/Documents/Somatic/APA Somatic Symptom Disorders description January29 2010.pdf
PDF B] Justification of Criteria - Somatic Symptoms DRAFT 1/29/10
http://www.dsm5.org/Documents/Somatic/APA DSM Validity Propositions 1-29-2010.pdf
**Review paper: CISSD Project leads Kroenke K, Sharpe M, Sykes R: Revising
the Classification of Somatoform Disorders: Key Questions and Preliminary
Recommendations. Psychosomatics 2007 Jul-Aug;48(4):277-85.
FREE Full Text: http://psy.psychiatryonline.org/cgi/content/full/48/4/277
18 Proposals submitted by Dr Richard Sykes to WHO ICD Update and Revision
Platform, Topical Advisory Group - Mental Health (TAGMH)
https://extranet.who.int/icdrevision/GroupPage.aspx?gcode=104
The paper: Kroenke K: Somatoform disorders and recent diagnostic
controversies. Psychiatr Clin North Am 2007 Dec;30(4):593-619.
http://www.ncbi.nlm.nih.gov/pubmed/17938036 contains the caveat:
"Although the CISSD is an ad hoc group that includes many international
experts on somatoform disorders, it was neither appointed nor sanctioned by
the APA or WHO, the organizations authorized to approve revisions of DSM
and ICD, respectively. As such, the CISSD recommendations should be
considered advisory rather than official. Also, there were some suggestions
for which the CISSD achieved near consensus but other issues where opinions
diverged considerably."
Suzy Chapman
_____________________
me.agenda@virgin.net
http://dxrevisionwatch.wordpress.com/
http://meagenda.wordpress.com
Protected by Kaspersky Lab
-
[if: MEagenda is amazing. In looking over the papers posted here, a number are literature reviews. I'm reminded of Ann Rand - medicine by committee........... Interesting the timing and topics of the articles and the proposed DSM-5 changes. (my bolds and colours)]
From Suzy Chapman
19 March 2010
There is a new MUS Rief paper published in the current (March '10) edition
of the Journal of Psychosomatic Research.
Also In Press papers by White (CFS: One discrete syndrome or many? FSSs);
Knoop, Prins, Moss-Morris, Bleijenberg (Central role of cognitive processes
in the perpetuation of chronic fatigue syndrome); Voigt, Lwe (Systematic
review of somatoform disorder diagnoses and suggestions for future
classification, DSM-5 and proposed new category CSSD, CISSD Project:
Kroenke, Sharpe, Sykes: example criteria); Escobar (3 or more concurrent
somatic symptoms predict psychopathology and service use); Henningsen,
Creed (Screening for multiple somatic complaints); Chalder (Measuring
fatigue).
Journal of Psychosomatic Research's Co-editor, Francis Creed, is a member of the APA's DSM-5 Somatic Symptom Disorder Work Group and had been a member of the CISSD Project.
Journal of Psychosomatic Research
Volume 68, Issue 3, Pages 219-316 (March 2010)
http://www.jpsychores.com/home
http://www.jpsychores.com/current
Current (March 10 issue)
Patients with medically unexplained symptoms and their significant others:
Illness attributions and behaviors as predictors of patient functioning
over time, 10 December 2009
Anja Hilbert, Alexandra Martin, Thomas Zech, Elisabeth Rauh, Winfried Rief
pages 253-262
Abstract | Full Text | Full-Text PDF (161 KB)
http://www.jpsychores.com/article/S0022-3999(09)00375-4/abstract
----------------------
Articles In Press
http://www.jpsychores.com/inpress
Chronic fatigue syndrome: Is it one discrete syndrome or many? Implications
for the "one vs. many" functional somatic syndromes debate
In Press Corrected Proof, Available online 18 March 2010
Peter D. White
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.008
Abstract | Full Text | Full-Text PDF (110 KB)
http://www.jpsychores.com/article/S0022-3999(10)00013-9/abstract
Chronic fatigue syndrome: Is it one discrete syndrome or many? Implications
for the "one vs. many" functional somatic syndromes debate
Peter D. White
Received 10 November 2009; received in revised form 12 January 2010;
accepted 14 January 2010. published online 18 March 2010.
Corrected Proof
Abstract
There is a current debate as to whether "functional somatic syndromes"
(FSSs) are more similar to or different from each other. While at the same
time, there is evidence of heterogeneity within single syndromes. So, it
could be that these syndromes are all part of one big process/illness, are
discrete in their own right, or that they are heterogeneous collections of
different illnesses lumped together by common symptoms but separated by
uncommon pathophysiologies. The example of chronic fatigue syndrome (CFS)
is instructive. There is evidence to support all three models of
understanding. Three recent large studies have suggested that FSSs are both
similar and dissimilar at the same time. The solution to the debate is that
we need to both "lump" and "split." We need to study both the similarities
between syndromes and their dissimilarities to better understand what we
currently call the FSSs.
Keywords: Functional somatic syndromes, Chronic fatigue syndrome,
heterogeneity, homogeneity, risk markers
Wolfson Institute of Preventive Health, Barts and The London School of
Medicine and Dentistry, Queen Mary University of London, London, UK
Department of Psychological Medicine, St Bartholomew's Hospital, London,
EC1A 7BE, UK. Tel.: +44 207 601 8108; fax: +44 207 601 7097.
PII: S0022-3999(10)00013-9
doi:10.1016/j.jpsychores.2010.01.008
2010 Published by Elsevier Inc.
----------------------
Articles in Press
http://www.jpsychores.com/inpress
The central role of cognitive processes in the perpetuation of chronic
fatigue syndrome
In Press Corrected Proof , Available online 17 March 2010
Hans Knoop, Judith B. Prins, Rona Moss-Morris, Gijs Bleijenberg
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.022
Abstract | Full Text | Full-Text PDF (122 KB)
http://www.jpsychores.com/article/S0022-3999(10)00063-2/abstract
The central role of cognitive processes in the perpetuation of chronic
fatigue syndrome
Hans Knoop a, Judith B. Prins b, Rona Moss-Morris c, Gijs Bleijenberg d
Received 8 November 2009; received in revised form 26 January 2010;
accepted 26 January 2010. published online 17 March 2010.
Corrected Proof
Abstract
Objective
Chronic fatigue syndrome (CFS) is considered to be one of the functional
somatic syndromes (FSS). Cognitions and behavior are thought to perpetuate
the symptoms of CFS. Behavioral interventions based on the existing models
of perpetuating factors are quite successful in reducing fatigue and
disabilities. The evidence is reviewed that cognitive processes,
particularly those that determine the perception of fatigue and its effect
on behavior, play a central role in the maintenance of symptoms.
Method
Narrative review.
Results
Findings from treatment studies suggest that cognitive factors mediate the
positive effect of behavioral interventions on fatigue. Increased fitness
or increased physical activity does not seem to mediate the treatment
response. Additional evidence for the role of cognitive processes is found
in studies comparing the subjective beliefs patients have of their
functioning with their actual performance and in neurobiological research.
Conclusion
Three different cognitive processes may play a role in the perpetuation of
CFS symptoms. The first is a general cognitive representation in which
fatigue is perceived as something negative and aversive and CFS is seen as
an illness that is difficult to influence. The second process involved is
the focusing on fatigue. The third element is formed by specific
dysfunctional beliefs about activity and fatigue.
Keywords: Chronic fatigue syndrome, Functional somatic syndromes,
Perpetuating factors, Treatment studies, Cognitive processes, Perception
a Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical
Centre, Nijmegen, The Netherlands
b Department of Medical Psychology, Radboud University Nijmegen Medical
Centre, Nijmegen, The Netherlands
c School of Psychology, University of Southampton, Southampton, United
Kingdom
d Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical
Centre, Nijmegen, The Netherlands
Corresponding author. Expert Centre Chronic Fatigue, Radboud University
Nijmegen Medical Centre, Postbox 9011 , 6500 HB Nijmegen, The Netherlands.
Tel.: +31 24 3610042; fax: +31 24 3610041.
This article was written while the first author was a visiting staff member
of the School of Psychology at the University of Southampton. The working
visit was made possible by a grant of the Dutch MSresearch fund (Stichting
MSresearch).
PII: S0022-3999(10)00063-2
doi:10.1016/j.jpsychores.2010.01.022
2010 Elsevier Inc. All rights reserved.
----------------------
Articles in Press
http://www.jpsychores.com/inpress
Towards positive diagnostic criteria: A systematic review of somatoform
disorder diagnoses and suggestions for future classification
In Press Corrected Proof , Available online 15 March 2010
Katharina Voigt, Annabel Nagel, Bjrn Meyer, Gernot Langs, Christoph
Braukhaus, Bernd Lwe
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.015
Abstract | Full Text | Full-Text PDF (183 KB)
Abstract
http://www.jpsychores.com/article/S0022-3999(10)00020-6/abstract
Towards positive diagnostic criteria: A systematic review of somatoform
disorder diagnoses and suggestions for future classification
Katharina Voigta 1, Annabel Nagel a1, Bjrn Meyer a, Gernot Langs b,
Christoph
Braukhaus b, Bernd Lwe a
Received 1 November 2009; received in revised form 12 January 2010;
accepted 14 January 2010. published online 15 March 2010.
Corrected Proof
Abstract
Objectives
The classification of somatoform disorders is currently being revised in
order to improve its validity for the DSM-V and ICD-11. In this article, we
compare the validity and clinical utility of current and several new
diagnostic proposals of those somatoform disorders that focus on medically
unexplained somatic symptoms.
Methods
We searched the Medline, PsycInfo, and Cochrane databases, as well as
relevant reference lists. We included review papers and original articles
on the subject of somatoform classification in general, subtypes of
validity of the diagnoses, or single diagnostic criteria.
Results
Of all diagnostic proposals, only complex somatic symptom disorder* and the
Conceptual Issues in Somatoform and Similar Disorders (CISSD)**
example criteria reflect all dimensions of current biopsychosocial models
of somatization (construct validity) and go beyond somatic symptom counts
by including psychological and behavioral symptoms that are specific to
somatization (descriptive validity). Predictive validity of most of the
diagnostic proposals has not yet been investigated. However, the number of
somatic symptoms has been found to be a strong predictor of disability.
Some evidence indicates that psychological symptoms can predict disease
course and treatment outcome (e.g., therapeutic modification of
catastrophizing is associated with positive outcome). Lengthy symptom
lists, the requirement of lifetime symptom report (as in abridged
somatization), complicated symptom patterns (as in current somatization
disorder), and imprecise definitions of diagnostic procedures (e.g.,
missing symptom threshold in complex somatic symptom disorder) reduce
clinical utility.
Conclusion
Results from the reviewed studies suggest that, of all current and new
diagnostic suggestions, complex somatic symptom disorder and the CISSD
definition appear to have advantages regarding validity and clinical
utility. The integration of psychological and behavioral criteria could
enhance construct and descriptive validity, and confers prospectively
relevant treatment implications. The incorporation of a dimensional
approach that reflects both somatic and psychological symptom severity also
has the potential to improve predictive validity and clinical utility.
Keywords: Classification, Diagnosis, Diagnostic and Statistical Manual of
Mental Disorders, International Classification of Diseases, Somatoform
disorders, Validation studies as topic
a Department of Psychosomatic Medicine and Psychotherapy, University
Medical Center Hamburg-Eppendorf and Schn Klinik Hamburg-Eilbek, Hamburg,
Germany
b Medical and Psychosomatic Hospital Bad Bramstedt, Bad Bramstedt, Germany
Corresponding author. Department of Psychosomatic Medicine and
Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52,
20246 Hamburg, Germany. Tel.: +49 40 7410 59733; fax: +49 40 7410 54975.
1 Both authors contributed equally to this paper.
PII: S0022-3999(10)00020-6
doi:10.1016/j.jpsychores.2010.01.015
2010 Elsevier Inc. All rights reserved.
----------------------
Articles in Press
http://www.jpsychores.com/inpress
Whether medically unexplained or not, three or more concurrent somatic
symptoms predict psychopathology and service use in community populations
In Press Corrected Proof , Available online 17 February 2010
Javier I. Escobar, Benjamin Cook, Chi-Nan Chen, Michael A. Gara, Margarita
Alegra, Alejandro Interian, Esperanza Diaz
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.001
http://www.jpsychores.com/article/S0022-3999(10)00006-1/abstract
Whether medically unexplained or not, three or more concurrent somatic
symptoms predict psychopathology and service use in community populations
Javier I. Escobar, MD ab, Benjamin Cook, PhD c, Chi-Nan Chen, PhD c,
Michael A. Gara, PhD abd, Margarita Alegra, PhD c, Alejandro Interian, PhD
ab, Esperanza Diaz, MD e
Received 6 May 2009; received in revised form 20 December 2009; accepted 5
January 2010. published online 17 February 2010.
Corrected Proof
Abstract
Objectives
To examine the frequency of somatic symptoms in a community population of
various ethnic backgrounds and to identify correlates of these symptoms
such as psychopathology, use of services, and personal distress.
Methods
Using a 14-symptom inventory with interviewer probes for somatic symptoms,
we determined the presence of general physical symptoms (GPS) in a sample
of 4864 white, Latino, and Asian US community respondents. Medically
"edited" verbatim interview responses were used to decide whether or not
physical symptoms would qualify as medically unexplained physical symptoms
(MUPS). We then assessed the association between GPS and MUPS and
psychiatric disorders, psychological distress, and use of services, in both
unadjusted and multivariate regression analyses.
Results
One-third (33.6%) of the respondents reported at least one GPS and 11.1%
reported at least one MUPS within the last year. 10.7% of respondents had
three or more GPS and 1.5% had three or more MUPS. Three or more GPS and
MUPS were positively associated with depressive, anxiety, and substance use
disorders; service use; and psychological distress in unadjusted
comparisons. In multivariate regressions, GPS persisted as a significant
predictor, but there was no significant independent effect of MUPS, after
controlling for GPS and other covariates.
Conclusions
Regardless of the presence or absence of medical explanations, physical
symptoms are an important component of common mental disorders such as
depression and anxiety and predict service use in community populations.
These results suggest that three or more current GPS can be used to
designate a "case" and that detailed probes and procedures aimed at
determining whether or not physical symptoms are medically unexplained may
not be necessary for classification purposes.
Keywords: Somatoform disorders, Epidemiology
a Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, New
Brunswick, NJ, USA
b Department of Family Medicine, UMDNJ-Robert Wood Johnson Medical School,
New Brunswick, NJ, USA
c Center for Multicultural Health Research, Cambridge Health
Alliance-Harvard Medical School, Somerville, MA, USA
d UMDNJ-University Behavioral Health Care (UBHC) Piscataway, NJ, USA
e Department of Psychiatry, Yale University School of Medicine, New Haven
CT, USA
Corresponding author.
PII: S0022-3999(10)00006-1
doi:10.1016/j.jpsychores.2010.01.001
2010 Published by Elsevier Inc.
----------------------
Articles in Press
http://www.jpsychores.com/inpress
Screening for multiple somatic complaints in a population-based survey:
Does excessive symptom reporting capture the concept of somatic symptom
disorders? Findings from the MONICA-KORA Cohort Study
In Press Corrected Proof , Available online 02 March 2010
Karl Heinz Ladwig, Birgitt Marten-Mittag, Maria Elena Lacruz, Peter
Henningsen, Francis Creed, for the MONICA KORA Investigators
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2010.01.009
Abstract | Full Text | Full-Text PDF (544 KB)
http://www.jpsychores.com/article/S0022-3999(10)00014-0/abstract
----------------------
Articles in Press
http://www.jpsychores.com/inpress
Measuring fatigue in clinical and community settings
In Press Corrected Proof , Available online 11 December 2009
Matteo Cella, Trudie Chalder
Journal of Psychosomatic Research
DOI: 10.1016/j.jpsychores.2009.10.007
Abstract | Full Text | Full-Text PDF (135 KB)
http://www.jpsychores.com/article/S0022-3999(09)00417-6/abstract
-----------------------------------------------------------------------------
Related material:
*The DSM-5 proposal is that Somatoform Disorders, Psychological Factors
Affecting Medical Condition (PFAMC), and Factitious Disorders should be
combined under a common rubric entitled "Somatic Symptom Disorders" and for
a new classification "Complex Somatic Symptom Disorder (CSSD)."
The DSM-5 public review period runs from 10 February to 20 April.
Members of the public, patient representation organisations, professionals
and other end users can submit responses, online.
Please take this opportunity to comment and to alert and encourage
professionals and international patient organisations to participate.
Proposed Draft Revisions to DSM Disorders and Criteria are published here
on the APA's relaunched DSM5.org website:
http://www.dsm5.org/Pages/Default.aspx
Somatoform Disorders:
http://www.dsm5.org/ProposedRevisions/Pages/SomatoformDisorders.aspx
Proposed new DSM-5 category: Complex Somatic Symptom Disorder
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=368
Two Key PDF documents are associated with proposals:
PDF A] Somatic Symptom Disorders Introduction DRAFT 1/29/10
http://www.dsm5.org/Documents/Somatic/APA Somatic Symptom Disorders description January29 2010.pdf
PDF B] Justification of Criteria - Somatic Symptoms DRAFT 1/29/10
http://www.dsm5.org/Documents/Somatic/APA DSM Validity Propositions 1-29-2010.pdf
**Review paper: CISSD Project leads Kroenke K, Sharpe M, Sykes R: Revising
the Classification of Somatoform Disorders: Key Questions and Preliminary
Recommendations. Psychosomatics 2007 Jul-Aug;48(4):277-85.
FREE Full Text: http://psy.psychiatryonline.org/cgi/content/full/48/4/277
18 Proposals submitted by Dr Richard Sykes to WHO ICD Update and Revision
Platform, Topical Advisory Group - Mental Health (TAGMH)
https://extranet.who.int/icdrevision/GroupPage.aspx?gcode=104
The paper: Kroenke K: Somatoform disorders and recent diagnostic
controversies. Psychiatr Clin North Am 2007 Dec;30(4):593-619.
http://www.ncbi.nlm.nih.gov/pubmed/17938036 contains the caveat:
"Although the CISSD is an ad hoc group that includes many international
experts on somatoform disorders, it was neither appointed nor sanctioned by
the APA or WHO, the organizations authorized to approve revisions of DSM
and ICD, respectively. As such, the CISSD recommendations should be
considered advisory rather than official. Also, there were some suggestions
for which the CISSD achieved near consensus but other issues where opinions
diverged considerably."
Suzy Chapman
_____________________
me.agenda@virgin.net
http://dxrevisionwatch.wordpress.com/
http://meagenda.wordpress.com
Protected by Kaspersky Lab
-