Psychological Factors Affecting Medical Conditions
A New Classification for DSM-V
Editor(s): Porcelli, P. (Castellana Grotte)Sonino, N. (Padova)
Psychological Factors Affecting Functional Gastrointestinal DisordersPorcelli P.a ยท Todarello O.baPsychosomatic Unit, IRCCS De Bellis Hospital, Castellana Grotte, and
bDepartment of Psychiatry, University of Bari, Bari, Italy
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Article / Publication Details
Published online: July 31, 2007
Cover Date: 2007
Number of Print Pages: 23
Number of Figures: 0
Number of Tables: 0
ISBN: 978-3-8055-8331-2 (Print)
eISBN: 978-3-8055-8374-9 (Online)
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
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Article / Publication Details
Published online: July 31, 2007
Cover Date: 2007
Number of Print Pages: 23
Number of Figures: 0
Number of Tables: 0
ISBN: 978-3-8055-8331-2 (Print)
eISBN: 978-3-8055-8374-9 (Online)
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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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