Complex post-traumatic stress disorder in patients with somatization disorder

Aust N Z J Psychiatry. 2009 Jan;43(1):80-6. doi: 10.1080/00048670802534366.

Abstract

Objective: Given the association between severe childhood trauma, adult somatization and complex post-traumatic stress disorder (cPTSD), the purpose of the present paper was to assess this syndrome and its clinical correlates in patients with somatization disorder (SD).

Methods: A total of 28 patients (82% women, mean age = 41.7+/-10.1 years) meeting DSM-IV criteria for SD as confirmed by the Structured Clinical Interview for DSM-IV, Axis I were compared to 28 age- and gender-matched patients with major depression, but without a lifetime diagnosis of SD. They completed the Structured Interview for Disorders of Extreme Stress, the Brief Symptom Inventory, the Inventory of Interpersonal Problems-Circumplex Scales, and the SF-36 Health Survey.

Results: Compared to the control group, SD patients had higher risks for current and lifetime diagnoses of cPTSD (odds ratio (OR) = 15.0, 95% confidence interval (CI) = 1.76-127.54; and OR = 8.33, 95%CI = 2.04-34.07, respectively). SD subjects with cPTSD had more psychological distress, more interpersonal problems and worse psychosocial functioning than those without the syndrome.

Conclusion: The concept of complex PTSD may hold clinical utility when applied to SD patients because it identifies a distinct subgroup characterized by severe psychosocial impairment. The diagnostic and therapeutic implications of the present findings are discussed.

MeSH terms

  • Adult
  • Child
  • Child Abuse / psychology
  • Child Abuse / statistics & numerical data
  • Child Abuse, Sexual / psychology
  • Child Abuse, Sexual / statistics & numerical data
  • Comorbidity
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology
  • Female
  • Germany
  • Humans
  • Interpersonal Relations
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Middle Aged
  • Psychopathology
  • Quality of Life / psychology
  • Risk Factors
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / epidemiology
  • Somatoform Disorders / psychology
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology