Abstract
Functional gastrointestinal disorders are a variable combination of chronic or recurrent medically unexplained gastrointestinal symptoms. They can be conceptualized within the biopsychosocial model of illness as a dysregulation of the brain-gut axis and its relationships with psychosocial variables (psychopathology, health care seeking, life events, somatosensory amplification). Psychopathology may be undetected with the standard psychiatric criteria, particularly at a subclinical level. Using the new classification of the Diagnostic Criteria for Psychosomatic Research (DCPR) for assessing psychosocial components of somatic illnesses, psychosomatic syndromes were found at a prevalence of 2.5 times greater than DSM-IV diagnoses. In particular, alexithymia, persistent somatization, functional somatic symptoms secondary to a psychiatric disorder, and demoralization were the most prevalent syndromes. Furthermore, psychosomatic severity (as measured with the presence of more than one DCPR conditions) strongly predicted the treatment outcome in patients with functional gastrointestinal disorders. In particular, alexithymia and persistent somatization were independent predictors of unimprovement (and health anxiety of improvement) after 6 months of treatment as usual, after controlling for gastrointestinal symptoms at baseline. DCPR may therefore be suggested as a reliable assessment instrument for psychological conditions that are relevant for psychosomatic practice and research settings but that are not included in the DSM-IV.
| Original language | English |
|---|---|
| Title of host publication | Advances in Psychosomatic Medicine |
| Pages | 34-56 |
| Number of pages | 23 |
| Volume | 28 |
| DOIs | |
| Publication status | Published - 2007 |
Publication series
| Name | Advances in Psychosomatic Medicine |
|---|---|
| Volume | 28 |
| ISSN (Print) | 00653268 |
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ASJC Scopus subject areas
- Psychiatry and Mental health
Cite this
Psychological factors affecting functional gastrointestinal disorders. / Porcelli, P.; Todarello, O.
Advances in Psychosomatic Medicine. Vol. 28 2007. p. 34-56 (Advances in Psychosomatic Medicine; Vol. 28).Research output: Chapter in Book/Report/Conference proceeding › Chapter
}
TY - CHAP
T1 - Psychological factors affecting functional gastrointestinal disorders
AU - Porcelli, P.
AU - Todarello, O.
PY - 2007
Y1 - 2007
N2 - Functional gastrointestinal disorders are a variable combination of chronic or recurrent medically unexplained gastrointestinal symptoms. They can be conceptualized within the biopsychosocial model of illness as a dysregulation of the brain-gut axis and its relationships with psychosocial variables (psychopathology, health care seeking, life events, somatosensory amplification). Psychopathology may be undetected with the standard psychiatric criteria, particularly at a subclinical level. Using the new classification of the Diagnostic Criteria for Psychosomatic Research (DCPR) for assessing psychosocial components of somatic illnesses, psychosomatic syndromes were found at a prevalence of 2.5 times greater than DSM-IV diagnoses. In particular, alexithymia, persistent somatization, functional somatic symptoms secondary to a psychiatric disorder, and demoralization were the most prevalent syndromes. Furthermore, psychosomatic severity (as measured with the presence of more than one DCPR conditions) strongly predicted the treatment outcome in patients with functional gastrointestinal disorders. In particular, alexithymia and persistent somatization were independent predictors of unimprovement (and health anxiety of improvement) after 6 months of treatment as usual, after controlling for gastrointestinal symptoms at baseline. DCPR may therefore be suggested as a reliable assessment instrument for psychological conditions that are relevant for psychosomatic practice and research settings but that are not included in the DSM-IV.
AB - Functional gastrointestinal disorders are a variable combination of chronic or recurrent medically unexplained gastrointestinal symptoms. They can be conceptualized within the biopsychosocial model of illness as a dysregulation of the brain-gut axis and its relationships with psychosocial variables (psychopathology, health care seeking, life events, somatosensory amplification). Psychopathology may be undetected with the standard psychiatric criteria, particularly at a subclinical level. Using the new classification of the Diagnostic Criteria for Psychosomatic Research (DCPR) for assessing psychosocial components of somatic illnesses, psychosomatic syndromes were found at a prevalence of 2.5 times greater than DSM-IV diagnoses. In particular, alexithymia, persistent somatization, functional somatic symptoms secondary to a psychiatric disorder, and demoralization were the most prevalent syndromes. Furthermore, psychosomatic severity (as measured with the presence of more than one DCPR conditions) strongly predicted the treatment outcome in patients with functional gastrointestinal disorders. In particular, alexithymia and persistent somatization were independent predictors of unimprovement (and health anxiety of improvement) after 6 months of treatment as usual, after controlling for gastrointestinal symptoms at baseline. DCPR may therefore be suggested as a reliable assessment instrument for psychological conditions that are relevant for psychosomatic practice and research settings but that are not included in the DSM-IV.
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UR - http://www.scopus.com/inward/citedby.url?scp=34547984007&partnerID=8YFLogxK
U2 - 10.1159/0000106796
DO - 10.1159/0000106796
M3 - Chapter
C2 - 17684319
AN - SCOPUS:34547984007
SN - 3805583311
SN - 9783805583312
VL - 28
T3 - Advances in Psychosomatic Medicine
SP - 34
EP - 56
BT - Advances in Psychosomatic Medicine
ER -