Ideas about the disease and its causes in patients with somatoform disorders: association with somatic complaints and subjective well-being

Ideas about the disease and its causes in patients with somatoform disorders: association with somatic complaints and subjective well-being

 

Authors

 

A.Sh. Tkhostov

Lomonosov Moscow State University, Moscow, Russian Federation

E.I. Rasskazova

Lomonosov Moscow State University, Moscow, Russian Federation

 

https://doi.org/10.26617/1810-3111-2022-4(117)-51-63

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2022; 4 (117):  51-63.

 

Abstract

Background. Severe emotional reactions to the disease, an erroneous understanding of the true causes of the disease, a focus on a decrease in the functional state of the body, a low level of personal control are factors in the deterioration of the quality of life and the chronification of both somatic and mental diseases, and in patients with somatoform disorders (SD) they may be associated with more pronounced psycho-emotional instability and features of psychopathological symptoms. Objective: identify the features of ideas about the disease and the causes of its formation and dynamics in patients with SD and to determine their association with the severity of psychosomatic complaints and subjective psychological well-being. Material. Based on the psychiatric (crisis) department of the A.K. Eramishantsev City Clinical Hospital of the Moscow Department of Health and the outpatient department of the private Medical Center“Irbis” between 2016 and 2020 100 patients aged 18-68 years, male and female, diagnosed according to ICD-10 SD (F45) and dissociative (conversion)disorder (F44) were examined. Methods. A battery of psychodiagnostic tests was used: the Somatoform Symptom Screening Scale, the Quality of Life and Satisfaction Questionnaire, the Disease Perceptions Questionnaire, and the Health Behavior Assessment Scale. Results. In patients with SD, despite their formally expressed confidence in the need for treatment, their mood for therapy of behavioral disorders and satisfaction with its results, the mechanisms for understanding the formation, development and prognosis of the disease are disturbed. The tendency of patients with SD to psycho-emotional experiences explains the stereotype of ideas about the disease: the lack of a correct interpretation of specific facts causes absence of self-confidence and confidence in others, an attitude towards a long course of the disease, and an overestimation of the negative consequences of the disease. In chronic pain syndrome and conversion against the background of complaints of moderate severity, there is an erroneous one-sided understanding of the real causes of the disease, a pronounced emotional response in the form of in-confidence in a possible improvement in the course of the disease and avoidance of cooperation with the therapist. Patients with SD consider various psychological factors to be the key factors determining the onset, development, and outcome of the disease. Impersonal attribution of the disease is more common in patients with undifferentiated SD. The idea of the disease as a cyclical and deepening process, caused by a series of adverse random events and characterized by negative consequences, prevails in patients with more pronounced complaints of somatoform symptoms. The representation of the disease as a long-term process of a life test, with irreparable consequences for the body, with a pronounced emotional reaction to a “dangerous” disease, projective attribution of the disease by external psychological factors determines the worst satisfaction with life and social functioning. Patients who are confident in the negative consequences of the disease and with a pronounced emotional reaction to it are characterized by signs of hypochondriacal behavior with an exaggerated focus on themselves and personal problems. The ability to establish constant personal control over the course of therapy, an adequate understanding of the disease is associated with greater satisfaction with health. Conclusions. Ideas about negative consequences, emotional response, personal control, understanding of the disease and attribution of the disease by a psychological factor are targets for psycho-correctional work with a contingent of patients with SD.

 

Keywords: somatoform disorders, subjective psychological well-being, representation of the disease, ideas about the causes and dynamics of the disease.

 

Article (pdf)

 

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Materials  

For citation: Tkhostov A.Sh., Rasskazova E.I. Ideas about the disease and its causes in patients with somatoform disorders: association with somatic complaints and subjective well-being.Siberian Herald of Psychiatry and Addiction Psychiatry.2022; 4 (117): 51-63. https://doi.org/10.26617/1810-3111-2022-4(117)-51-63

REFERENCES

  1. BelokrylovIV, SemikovSV, TkhostovASh, RasskazovaEI. Group-analytical psychotherapy of patients with somatoform disorders: clinical efficacy, quality of life dynamics, attitudes towards illness and treatment. Psychiatry. 2022;20(1):76-88. DOI https://doi.org/10.30629/2618-6667-2022-20-1-76-88(in Russian).
  2. Belokrylov IV, Semikov SV, Tkhostov AS, Rasskazova EI. Hypochondriac Beliefs and Behavior in Patients with Somatoform Disorders: Relationship to Somatic Complaints and Subjective Well-Being. Psikhiatriya. 2021;19(3):58-67. https://doi.org/10.30629/2618-6667-2021-19-3-58-67(in Russian).
  3. Yeresko DB, Isurina GL, Kaydanovskaya YeV, Karvasarsky BD, Karpova EB, Korepanova TG, Krylova GS, Tarkhan AU, Chekhlaty YeI, Shifrin VB. Alexithymia and methods of its definition in borderline psychosomatic disorders: A guide for psychologists and doctors. St. Petersburg, 2005:25(in Russian).
  4. Rasskazova EI. Russian-language approbation of the disease perception questionnaire R. Moss-Morris et al.: approbation on a sample of patients with non-psychotic depression. Bulletin of the Moscow University. Series 14. Psychology. 2016;1:123-142(in Russian).
  5. Rasskazova E.I. Clinical and psychological approach to the diagnosis of difficult-to-qualify symptoms within somatoform disorders. Bekhterev Review of Psychiatry and Medical Psychology. 2013;3:25-32(in Russian).
  6. Rasskazova EI. Methodology for assessing the quality of life and satisfaction: psychometric characteristics of the Russian version. Psychology. Journal of the Higher School of Economics. 2012;9(4):81-90(in Russian).
  7. Tkhostov ASh. Psychology of body sense. Moscow: Smysl Publishing House, 2002. 287 (in Russian).
  8. Barsky AJ, Wyshak G. Hypochondriasis and somatosensory amplification. Br J Psychiatry. 1990 Sep;157:404-9. doi: 10.1192/bjp.157.3.404. PMID: 2245272.
  9. Frostholm L, Petrie KJ, Ornbøl E, Fink P. Are illness perceptions related to future healthcare expenditure in patients with somatoform disorders? Psychol Med. 2014 Oct;44(13):2903-11. doi: 10.1017/S003329171400035X. Epub 2014 Mar 3. PMID: 25066790.
  10. Jungmann SM, Witthöft M. Medically unexplained symptoms in children and adolescents: Illness-related self-concept and parental symptom evaluations. J Behav Ther Exp Psychiatry. 2020 Sep;68:101565. doi: 10.1016/j.jbtep.2020.101565. Epub 2020 Mar 2. PMID: 32171996.
  11. Hagger Martin, Orbell Sh. A Meta-Analytic Review of the Common-Sense Model of Illness Representations. Psychology & Health. 2003;18:141-184. 10.1080/088704403100081321.
  12. Hulgaard DR, Rask CU, Risor MB, Dehlholm G. Illness perceptions of youths with functional disorders and their parents: An interpretative phenomenological analysis study. Clin Child Psychol Psychiatry. 2020 Jan;25(1):45-61. doi: 10.1177/1359104519846194. Epub 2019 May 13. PMID: 31079473.
  13. Hüsing P, Löwe B, Piontek K, Shedden-Mora M. Somatoform disorder in primary care: The influence of co-morbidity with anxiety and depression on health care utilization. J Eval Clin Pract. 2018 Aug;24(4):892-900. doi: 10.1111/jep.12898. Epub 2018 Mar 2. PMID: 29498165.
  14. Leventhal H, Brissette I, Leventhal E. The common-sense model of self-regulation of health and illness / In L.D. Cameron, H. Leventhal (Eds.) The self-regulation of health and illness behavior. Routledge: New York, 2003. P. 42-65.
  15. McAndrew LM, Musumeci-Szabó TJ, Mora PA, Vileikyte L, Burns E, Halm EA, Leventhal EA, Leventhal H. Using the common sense model to design interventions for the prevention and management of chronic illness threats: from description to process. Br J Health Psychol. 2008 May;13(Pt 2):195-204. doi: 10.1348/135910708X295604. Epub 2008 Mar 7. PMID: 18331667.
  16. Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychology and Health. 2002;17(1):1-16. https://doi.org/10.1080/08870440290001494
  17. Rief W, Hiller W. A new approach to the assessment of the treatment effects of somatoform disorders. Psychosomatics. 2003 Nov-Dec;44(6):492-8. doi: 10.1176/appi.psy.44.6.492. PMID: 14597684.
  18. Rief W, Hiller W, Margraf J. Cognitive aspects of hypochondriasis and the somatization syndrome. J Abnorm Psychol. 1998 Nov;107(4):587-95. doi: 10.1037//0021-843x.107.4.587. PMID: 9830246.
  19. Rief W, Ihle D, Pilger F. A new approach to assess illness behaviour. J Psychosom Res. 2003 May;54(5):405-14. doi: 10.1016/s0022-3999(02)00401-4. PMID: 12726894.
  20. Ritsner M, Kurs R, Gibel A, Ratner Y, Endicott J. Validity of an abbreviated quality of life enjoyment and satisfaction questionnaire (Q-LES-Q-18) for schizophrenia, schizoaffective, and mood disorder patients. Qual Life Res. 2005 Sep;14(7):1693-703. doi: 10.1007/s11136-005-2816-9. PMID: 16119181.
  21. Wiborg JF, Löwe B. Illness perceptions in patients with somatoform disorders: examining the role of comorbidity. J Health Psychol. 2015 Sep;20(9):1166-74. doi: 10.1177/1359105313509843. Epub 2013 Dec 12. PMID: 24335537.