Psychopathologies and quality of life in mental and functional disorders associated with persistent somatic symptoms

Persistent somatic symptoms (PSS) are a central diagnostic feature of several mental and functional disorders. However, only several studies simultaneously considered disorders from different systems. The purpose of this study was to explore the coexisting status of these diagnoses and to analyze the relationship between diagnoses and various psychopathologies, as well as quality of life (QOL).

We recruited participants from psychosomatic clinics and neighboring communities of a hospital. All individuals underwent semi-structured interviews covering functional and mental disorder diagnoses and completed self-administered scales measuring somatic distress, health anxiety, depression, anxiety, and QOL. The relationships between diagnoses, psychopathologies, and QOL were explored.

This cross-sectional study included 502 individuals (mean age 44.54 years, 38.8 % males). Among the various diagnoses with PSS, the DSM-IV's undifferentiated somatoform disorder (USD) and DSM-5's somatic symptom disorder (SSD) were the most common. SSD had a high comorbidity rate with generalized anxiety disorder (GAD), major depressive disorder (MDD), and panic disorder. The diagnosis most strongly associated with the severity of somatic distress and health anxiety was the DSM-IV USD and DSM-5 SSD, respectively. MDD, GAD, panic disorder, and adjustment disorder had significant associations with various psychopathologies and QOL. Among the diagnoses with PSS, the DSM-IV USD had the highest correlation with QOL, primarily in the overall and physical domains.

The clinical sample was collected from psychosomatic clinics and cannot represent other medical settings.

DSM-IV USD and DSM-5 SSD were the diagnoses with PSS most extensively and significantly associated with psychopathologies and QOL.