Persistent somatization in cancer: a controlled follow-up study

Nature and frequency of somatic complaints, severity of anxiety and depression, and nature of psychiatric symptoms and disorders were evaluated in 81 adequately treated cancer patients, disease-free or with residual disease, using a controlled, prospective follow-up design. Patients were included in the index group (n=60) if they had persistent somatic complaints or unexplained nature or severity of somatic complaints, or the control group (n=21), if they did not report somatic complaints. Instruments used for evaluation were the Scale for Assessment of Somatic Symptoms, Hospital Anxiety and Depression Scale, Psychiatric Assessment Schedule, and DSM-III-R. Common somatic complaints in the index group were pain (19%), fatigue (17%), sensory symptoms (30%), and mixed symptoms (27%). Subjects in the index group significantly (p<0.001) more often had depressive or anxiety disorder (19%) and atypical somatoform disorder (15%). Patients were treated appropriately with psychotropic medications and counseling. Follow-up at 4-6 months revealed a significant reduction in the number of somatic symptoms (p<0.001) and anxiety (p<0.001) and depression (p<0.05) scores. The observations confirm that somatic symptoms may persist in cancer patients, which are related to concomitant psychopathology, and require psychiatric intervention.