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Psychological factors affecting functional gastrointestinal disorders.
Piero Porcelli1, Orlando Todarello
1Psychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, Italy.
Advances in Psychosomatic Medicine
|August 9, 2007
Summary
The Diagnostic Criteria for Psychosomatic Research (DCPR) identified more psychosomatic syndromes in functional gastrointestinal disorders than standard criteria. These syndromes significantly impact treatment outcomes, highlighting the need for broader psychological assessments.
Area of Science:
- Gastroenterology
- Psychiatry
- Psychosomatic Medicine
Background:
- Functional gastrointestinal disorders involve chronic, unexplained symptoms.
- These disorders are understood through the biopsychosocial model, involving brain-gut axis dysregulation and psychosocial factors.
- Subclinical psychopathology can be missed by standard psychiatric evaluations.
Purpose of the Study:
- To evaluate the prevalence of psychosomatic syndromes using the Diagnostic Criteria for Psychosomatic Research (DCPR) in functional gastrointestinal disorders.
- To determine the predictive value of these syndromes on treatment outcomes.
- To compare DCPR diagnoses with DSM-IV criteria for assessing psychosocial components.
Main Methods:
- Utilized the Diagnostic Criteria for Psychosomatic Research (DCPR) to assess psychosocial factors in patients with functional gastrointestinal disorders.
- Compared the prevalence of DCPR-identified syndromes with DSM-IV diagnoses.
- Analyzed the relationship between psychosomatic severity (multiple DCPR conditions) and treatment outcomes at 6 months.
Main Results:
- Psychosomatic syndromes were 2.5 times more prevalent with DCPR than DSM-IV diagnoses.
- Alexithymia, persistent somatization, functional somatic symptoms secondary to psychiatric disorders, and demoralization were the most common syndromes.
- Psychosomatic severity, specifically alexithymia and persistent somatization, predicted poorer treatment outcomes (unimprovement), while health anxiety predicted improvement.
Conclusions:
- DCPR offers a more comprehensive assessment of psychological conditions relevant to functional gastrointestinal disorders compared to DSM-IV.
- Psychosomatic syndromes identified by DCPR are significant predictors of treatment response.
- DCPR is a valuable tool for psychosomatic research and clinical practice in functional gastrointestinal disorders.
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