Personality Disorders in Patients with Somatisation Disorder

Abstract

Twenty-five women with somatisation disorder (SD) were compared with matched patient controls for the presence of personality disorders. Personality was assessed with the Personality Assessment Schedule (PAS). Interviewers were unaware of the patients' diagnoses. All controls had DSM-III-R axis I diagnoses of depressive or anxiety disorders. The prevalence of personality disorders among patients with somatisation disorder was 72% compared with 36% among controls. Certain personality disorders, including passive-dependent, histrionic, and sensitive-aggressive, occurred significantly more often in the SD patients than controls.

Personality disorders in somatization disorder patients: A controlled study in Spain

“…There were two reasons for selecting patients with psychiatric disorders, more specifically mood and/or anxiety disorders: (a) mood and/or anxiety disorders are the most prevalent Axis I comorbidity in SD patients and, therefore, this would be an opportunity to partially control this variable in SD patients; and (b) the other even more important reason was to exactly replicate the only previous controlled study on this subject [4], in which the authors used this control group. Consequently, a group of psychiatric outpatients who were fluent in Spanish was selected, recruited from the same setting as the SD patients, and diagnosed with depressive and/or anxiety disorders.…”

“…In fact, several authors consider somatoform disorders as a form of PD and believe that they should not be included in the Diagnostic and Statistical Manual (DSM) Axis I, but in Axis II disorders instead [5]. Unfortunately, there is only one controlled study on this subject [4], which is in need of replication. Moreover, despite the acceptance of the great influence of transcultural factors on the prevalence and expression of both SD and PD [6], all prior studies on PD and SD have been developed in Western English-speaking countries.…”

“…From the few published studies on personalities in SDs [2][3][4], it is widely accepted that the association between personality disorders (PDs) and SDs is frequent and intense, and appears early in the history of the patient. In fact, several authors consider somatoform disorders as a form of PD and believe that they should not be included in the Diagnostic and Statistical Manual (DSM) Axis I, but in Axis II disorders instead [5].…”

Distinguishing between Hypochondriasis and Somatization Disorder: A Review of the Existing Literature

“…In many instances, these links were based on clinical impressions of psychiatric patients that were not confirmed when structured interviews were applied. Interview studies found that, while more somatization disorder than control patients had personality disorders, the increase was non-specific [78, 79]. …”

A 1-year follow-up study of chest-pain patients with and without panic disorder

“…First, the presence of a personality disorder may be a possible confounder as it often coexists with somatization disorder (72%) (125) and may negatively affect the outcome of PD (67). At baseline, significantly more of the PD than NoPD patients suffered from avoidant and borderline personality disorders (23.7% vs. 7.7% and 12.5% vs. 2.5 %) (126) but we did not find an association between presence of a personality disorder at baseline and PD persistence after nine years (paper II).…”