Childhood maltreatment in patients with somatization disorder

There is converging evidence indicating a close association between trauma, particularly childhood trauma, and adult somatization, but studies using both structured interviews and self-report measures to assess childhood adversities in patients with somatization disorder are scarce.

A total of 28 patients (82% women, mean age=41.7+/-10.1 years) meeting DSM-IV criteria for somatization disorder as confirmed by the Structured Clinical Interview for DSM-IV, Axis I (SCID-I) underwent the Structured Trauma Interview (STI) and the Childhood Trauma Questionnaire (CTQ). The comparison group consisted of 28 patients with major depression, but without a lifetime diagnosis of somatization disorder matched for gender and age.

Univariate analyses of both the STI and the CTQ data showed that somatizing patients had been exposed to childhood sexual and physical abuse significantly more often than major depressive disorder (MDD) patients. In logistic regression analysis with somatization disorder as the dependent variable, sexual abuse emerged as the only significant predictor, and the odds of having been sexually abused were ninefold higher in patients with somatization disorders relative to MDD subjects (odds ratio=9.39; 95% confidence interval=1.73-50.96). There were no differences between somatizing and depressed participants with respect to other types of maltreatment.

Childhood sexual abuse is an important factor in the multifactorial aetiopathogenesis of somatization disorder. Diagnostic and therapeutic implications are discussed.