Perception and Impact of Life Events in Medically Hospitalized Patients With Somatic Symptom and Related Disorders

We describe the prevalence and perceived impact of life events reported by medically hospitalized patients with somatic symptom and related disorders (SSRD) and highlight patient characteristics and outcomes associated with highly impactful life events.

Retrospective chart reviews were conducted of patients with SSRD at a tertiary pediatric hospital who were seen by the psychiatry consultation service and completed various instruments while medically admitted, including a de novo life events checklist. Descriptive statistics, correlations, χ² tests, and internal consistency analyses were used.

Charts of 70.2% of patients with SSRD who completed the life events checklist (N = 172; age range 8-25 years) were reviewed. Of those studied, 94% reported at least 1 life event in the last year, with academic events most prevalent, 81% reported life events across multiple domains, and 56% perceived the life event(s) as having a great impact on their lives. Patients who perceived more great impact life events were older, from households with lower median incomes, had higher self-reported somatization, greater functional disability, more comorbid psychiatric diagnoses, required more psychotropic medications, and had longer medical admissions.

Findings reveal that although the majority of medically hospitalized patients with SSRD reported at least 1 relevant life event, it was the patients' perception of the impact of the life event(s) that correlated with high levels of disability and health care use. An assessment of the perception of life events in patients with SSRD may help hospitalists and interdisciplinary providers identify high-risk patients for whom early psychiatry referrals can be made.