The Zurich Study: XXII

Hochstrasser, Barbara; Angst, Jules

doi:10.1007/bf02190278

Cited by 42 publications

(12 citation statements)

References 44 publications

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“…No firm conclusions can thus be drawn as to their reliability, validity and prognostic value. The findings of this study are, however, consistent with the available literature on FGID as to the high comorbidity of the mood and anxiety disorders [13, 14, 15, 16, 17], the presence of other, non-gastrointestinal-related, medically unexplained symptoms [49, 50, 51]and the low pain threshold in bodily sites beyond the symptom-related region of the gastrointestinal tract [52]. They are also consistent with the growing awareness of the importance of subclinical affective symptomatology [53, 54], particularly in the medical setting [22].…”

Section: Discussionsupporting

confidence: 79%

“…These patients have been found in fact to present with considerable psychological and psychiatric problems in a number of investigations [13, 14, 15, 16, 17]. The preliminary results on 70 of these patients have already been reported [18].…”

Section: Introductionmentioning

confidence: 83%

“…A consistent body of literature has indicated a very high prevalence of psychological disturbances in patients with FGID seeking medical care for their symptoms [13, 14, 15, 16, 17]. These patients thus offer an exellent opportunity of assessing the performance of different sets of criteria.…”

Section: Discussionmentioning

confidence: 99%

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Assessing Somatization in Functional Gastrointestinal Disorders: Integration of Different Criteria

Porcelli¹,

Carne²,

Fava

2000

Psychother Psychosom

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Background: Psychiatric assessment of somatization (the tendency to experience and communicate psychological distress in the form of physical symptoms and to seek medical help for them) currently rests on DSM criteria. An alternative diagnostic and conceptual framework has been proposed by an international group of psychosomatic investigators. The aim of this study was to compare these new criteria (Diagnostic Criteria for Psychosomatic Research, DCPR) with DSM-IV in a population where a high prevalence of psychosocial problems is expected (functional gastrointestinal disorders, FGID). Method: One hundred and ninety consecutive patients with FGID in a tertiary care center were assessed according to DSM-IV and DCPR criteria. Results: The number of the 12 DCPR diagnoses was almost double that of DSM diagnoses. Only 9% of the patients were not identified by DCPR criteria, whereas this occurred in 25% of patients using DSM criteria. While patients who were given a DSM diagnosis frequently had additional DCPR diagnoses, many patients with DCPR syndromes did not fulfill any DSM criteria. Four DCPR syndromes appared to be particularly frequent and accounted for almost three quarters of the total diagnoses (alexithymia, persistent somatization, functional symptoms secondary to a psychiatric disorder, demoralization). Conclusions: The joint use of DSM and DCPR criteria was found to improve the identification of psychological factors in FGID. The results may pave the way for changes in DSM classification of somatoform disorders.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 83%

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Assessing Somatization in Functional Gastrointestinal Disorders: Integration of Different Criteria

Porcelli¹,

Carne²,

Fava

2000

Psychother Psychosom

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“…The psychiatric comorbidity in FGIDs is a challenging diagnostic task for both gastroenterologists and psychiatrists. Although a high prevalence of psychopathology among patients with FGIDs has been demonstrated in several studies [7, 28, 29, 30], and the pathophysiology of FGIDs is conceptually close to the process of somatization [3], the exclusion rule of the DSM-IV may constitute an important limitation to the recognition of comorbidity, and produce a risk for underdiagnosing FGIDs in psychiatric settings. According to the DSM-IV, somatoform disorders are not diagnosed if the medically unexplained somatic symptoms are accounted for better by another mental disorder, particularly a mood or anxiety disorder.…”

Section: Discussionmentioning

confidence: 99%

Alexithymia and Psychopathology in Patients with Psychiatric and Functional Gastrointestinal Disorders

Porcelli¹,

Affatati

Bellomo

et al. 2004

Psychother Psychosom

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Background: Alexithymia and psychopathology may influence the way individuals experience psychological distress and somatic symptoms. This study evaluated patients referred to psychiatric and gastroenterologic outpatient settings in order to investigate the levels of alexithymia and psychopathology, and the possible role of alexithymia in symptom perception and health care utilization. The association between psychiatric disorders and functional gastrointestinal disorders (FGIDs) was also assessed. Methods: Psychopathology (by the Revised 90-item Symptom Checklist), alexithymia (by the 20-item Toronto Alexithymia Scale), and gastrointestinal symptoms (by the Gastrointestinal Symptom Rating Scale) were evaluated in 52 psychiatric outpatients and 58 medical outpatients with FGIDs. Two comorbid subgroups of 25 psychiatric patients with FGIDs and 38 FGID patients with psychiatric disorders were formed and compared. Results: Forty-eight percent of the psychiatric patients had associated FGIDs, and 65.5% of the FGID patients had associated psychiatric disorders. The FGID patients had significantly less psychopathology, but significantly higher alexithymia and more severe gastrointestinal symptoms, than the psychiatric patients. In the comparison of the two subgroups with comorbidity, FGID patients with psychiatric disorders were still more alexithymic and had less psychopathology than psychiatric patients with FGIDs, but gastrointestinal symptoms were not significantly different. Conclusion: Patients with ‘functional’ gastrointestinal symptoms attending a medical care service are likely to be highly alexithymic, whereas those attending a psychiatric care service are likely to show severe psychopathology. Alexithymia seems to influence the presentation of ‘functional’ somatic symptoms and the type of health care utilization.

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“…Klonoff et al [13] already provided a description of fear of nausea which was closely related to current definitions of fear of vomiting, in line with the idea that nausea may be particularly relevant to the etiological processes in SPOV. Further, nausea correlates with anxiety [14] and gastrointestinal complaints appear to be significantly associated with a number of anxiety disorders [15]. In addition, while nausea or gastrointestinal symptoms are acknowledged as secondary symptoms in social phobia [15,16] they could play a more crucial and central role in the development of SPOV.…”

Section: Introductionmentioning

confidence: 99%

Nausea in Specific Phobia of Vomiting

Höller

Overveld

Jutglar

et al. 2013

Behavioral Sciences

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Specific phobia of vomiting (SPOV) is a clinical condition with early onset, chronic course and substantial psychosocial impairment due to a rigorous avoidance behavior. A primary symptom which drives patients to consult a medical practitioner is nausea. In this study our aim was to further analyze this symptom of SPOV and examined its role in the development and manifestation of the phobia. We conducted an internet survey in the german SPOV-internet-forum. We calculated a nausea score and grouped participants in a high-and low-nausea group to examine the relationship between nausea and characteristics of the fear of vomiting. In this sample (N = 131), nausea was fairly common in most participants with fear of vomiting. Participants in the high-nausea group had significantly higher ratings of subjective fear and significantly longer duration of fear of vomiting. Additionally, the high-nausea group contained more participants with a body mass index below 19 than the low-nausea group. The present findings suggest that nausea is a core symptom in SPOV which is closely related to intensity of the fear, duration of the fear, and body weight. Future research should investigate if nausea-specific design of treatment could improve therapy outcome.

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The Zurich Study: XXII

Cited by 42 publications

References 44 publications

Assessing Somatization in Functional Gastrointestinal Disorders: Integration of Different Criteria

Assessing Somatization in Functional Gastrointestinal Disorders: Integration of Different Criteria

Alexithymia and Psychopathology in Patients with Psychiatric and Functional Gastrointestinal Disorders

Nausea in Specific Phobia of Vomiting

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