Exploring Associations of Somatic Symptom Disorder with Personality Dysfunction and Specific Maladaptive Traits.

IF 1.9 3区医学 Q3 PSYCHIATRY Psychopathology Pub Date : 2024-09-06 DOI:10.1159/000540161

Victoria von Schrottenberg, André Kerber, Philipp Sterner, Clara Teusen, Pauline Beigel, Klaus Linde, Peter Henningsen, Sabine C Herpertz, Jochen Gensichen, Antonius Schneider

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Abstract

Introduction: According to ICD-11, personality disorders (PDs) are defined by the severity of self and interpersonal dysfunction in terms of personality functioning (PF) and an optional assessment of specific maladaptive personality trait expressions. Also, somatoform disorders are replaced by somatic symptom disorder (SSD). This study examines associations using the novel diagnostic criteria of SSD in an unselected primary care sample, PF, and maladaptive traits in patients with and without SSD.

Methods: An anonymized cross-sectional study was conducted. A questionnaire including SSD-12 (Somatic Symptom Disorder B Criteria Scale-12) and PHQ-15 (Patient Health Questionnaire-15), LPFS-BF 2.0 (Level of Personality Functioning Scale - Brief Form) and PID-5BF+M (Modified Personality Inventory for DSM-5 - Brief Form Plus) was used. A bifactor (S-1) model was calculated with PF (reference for general factor) and personality traits (specific factors) to estimate associations between PF, specific maladaptive personality traits, and SSD. Differences in personality scales between SSD and non-SSD patients were calculated with the Mann-Whitney U test.

Results: A total of 624 patients in six general practices participated (mean age 47 years; 60.4% female). SSD-12 and PHQ-15, respectively, showed significant associations with PF (γ = 0.51; γ = 0.48; p < 0.001), negative affectivity (γ = 0.50; γ = 0.38, p < 0.001) and psychoticism (γ = 0.29; γ = 0.28; p < 0.010). Besides, SSD-12 was significantly associated with disinhibition (γ = -0.38; p < 0.010) and anankastia (γ = -0.16; p < 0.010). Patients with SSD showed significantly impaired PF and maladaptive traits in all scales (p < 0.001).

Conclusion: Impaired PF explains moderate to large amounts of the SSD symptoms and maladaptive personality traits negative affectivity, psychoticism, disinhibition, and anankastia show specific associations beyond PF. An in-depth understanding of these relations might be helpful to improve doctor-patient communication and treatment in SSD.

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探索躯体症状障碍与人格功能障碍和特定适应不良特质的关联。

导言：根据《国际疾病分类》第 11 版，人格障碍（PDs）是根据人格功能（PF）方面的自我和人际功能障碍的严重程度以及对特定适应不良人格特质表现的可选评估来定义的。此外，躯体形式障碍也被躯体症状障碍（SSD）所取代。本研究采用新的躯体症状障碍诊断标准，对未入选的初级保健样本、人格功能以及患有和未患有躯体症状障碍的患者的适应不良性格特征进行了研究：方法：进行了一项匿名横断面研究。调查问卷包括 SSD-12（躯体症状障碍 B 标准量表-12）、PHQ-15（患者健康问卷-15）、LPFS-BF 2.0（人格功能水平量表-简表）和 PID-5BF+M（DSM-5 修正人格量表-简表+）。计算了一个双因子（S-1）模型，用人格功能量表（一般因子参考）和人格特质（特定因子）来估计人格功能量表、特定适应不良人格特质和 SSD 之间的关联。SSD 患者与非 SSD 患者的人格量表差异采用 Mann-Whitney U 检验进行计算：共有六家全科诊所的 624 名患者（平均年龄 47 岁；60.4% 为女性）参加了调查。SSD-12和PHQ-15分别与PF (γ = 0.51; γ = 0.48; p < 0.001)、负性情感(γ = 0.50; γ = 0.38, p < 0.001)和精神病性(γ = 0.29; γ = 0.28; p < 0.010)显著相关。此外，SSD-12 与抑制（γ = -0.38；p <；0.010）和自闭（γ = -0.16；p <；0.010）明显相关。SSD患者在所有量表中都显示出明显的PF受损和适应不良特质（p < 0.001）：结论：PF受损可解释中度至大量的SSD症状，而不良人格特质负性情感、精神病性、抑制性和anankastia则显示出PF之外的特殊关联。深入了解这些关系可能有助于改善 SSD 的医患沟通和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychopathology 医学-精神病学

CiteScore

5.10

自引率

5.60%

发文量

审稿时长

>12 weeks

期刊介绍： ''Psychopathology'' is a record of research centered on findings, concepts, and diagnostic categories of phenomenological, experimental and clinical psychopathology. Studies published are designed to improve and deepen the knowledge and understanding of the pathogenesis and nature of psychopathological symptoms and psychological dysfunctions. Furthermore, the validity of concepts applied in the neurosciences of mental functions are evaluated in order to closely bring together the mind and the brain. Major topics of the journal are trajectories between biological processes and psychological dysfunction that can help us better understand a subject’s inner experiences and interpersonal behavior. Descriptive psychopathology, experimental psychopathology and neuropsychology, developmental psychopathology, transcultural psychiatry as well as philosophy-based phenomenology contribute to this field.