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Is all we know that we know nothing? A critical review of the prevalence of somatoform disorders in the elderly

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DOI: 10.4236/ojpsych.2013.34040    3,128 Downloads   4,437 Views   Citations

ABSTRACT

Objective: As noted in previous reviews, the prevalence rates for somatoform disorders in the elderly that have been reported are highly heterogeneous. The main aim of this paper is to identify the reasons for the substantial variation in prevalence rates and discuss the potential of future diagnostic criteria to address current difficulties. Methods: We conducted a selective review of the literature on the prevalence of somatoform disorders in elderly populations. Results: We found significant conceptual differences between the described diagnostic groups and the criteria applied across studies. Moreover, substantial disparities related to sample selection, age cut-offs, and applied measures were revealed. Conclusions: A general conceptual confusion exists throughout the literature regarding somatoform disorders in the elderly that significantly hinder the comparison and integration of results and can lead to premature conclusions. The redefinition of the somatoform disorder category in the next version of the DSM should be taken as an opportunity to address this issue and facilitate research.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Dehoust, M. , Schulz, H. , Härter, M. and Andreas, S. (2013) Is all we know that we know nothing? A critical review of the prevalence of somatoform disorders in the elderly. Open Journal of Psychiatry, 3, 375-383. doi: 10.4236/ojpsych.2013.34040.

References

[1] Hanel, G., Henningsen, P., Herzog, W., Sauer, N., Schaefert, R., Szecsenyi, J., et al. (2010) Depression, anxiety, and somatoform disorders: Vague or distinct categories in primary care? Results from a large cross-sectional study. Journal of Psychosomatic Research, 67, 189-197. http://dx.doi.org/10.1016/ j.jpsychores.2009.04.013
[2] Witthoft, M. and Hiller, W. (2010) Psychological approaches to origins and treatments of somatoform disorders. Annual Review of Clinical Psychology, 6, 257-283. http://dx.doi.org/10.1146/ annurev.clinpsy.121208. 131505
[3] Jacobi, F., Wittchen, H., Holting, C., H?fler, M., Pfister, H., Müller, N., et al. (2004) Prevalence, co-morbidity and correlates of mental disorders in the general population: Results from the german health interview and examination survey (GHS). Psychological Medicine, 54, 597-611. http://dx.doi.org/ 10.1017/S0033291703001399
[4] Meyer, C., Rumpf, H., Hapke, U., Dilling, H. and John, U. (2000) Lifetime prevalence of mental disorders in the adult general population: Findings from the TACOS study. Der Nervenarzt, 71, 535-542. http://dx.doi.org/10.1007/s001150050623
[5] Canino, G.J., Bird, H.R., Shrout, P.E., Rubio-Stipec, M., Bravo, M., Martinez, R., et al. (1987) The prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry, 44, 727-735. http://dx.doi.org/10.1001/archpsyc.1987.01800200053008
[6] Wells, J.E., Bushnell, J.A., Hornblow, A.R., Joyce, P.R. and Oakley-Browne, M.A. (1989) Christchurch epidemiology study: Part I. Methodology and lifetime prevalence for specific psychiatric disorders. Australian & New Zealand Journal of Psychiatry, 23, 315-326. http://dx.doi.org/10.3109/0004867890 9068289
[7] Helmchen, H., Baltes, M., Geiselmann, B., Kanowski, S., Linden, M., Reischies, F., et al. (1996) Psychische erkrankungen im alter. In: Mayer, K. and Baltes, P., Eds., Die Berliner Alterstudie, Akademie Verlag, Berlin, 185-220.
[8] Wijeratne, C., Brodaty, H. and Hickie, J. (2003) The neglect of somatoform disorders by old age psychiatry: Some explanations and suggestions for future research. International Journal of Geriatric Psychiatry, 18, 812-819. http://dx.doi.org/10.1002/gps.925
[9] Hilderink, P., Collard, R., Rosmalen, J. and OudeVoshaar, R. (2013) Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups: A systematic review. Ageing Research Reviews, 12, 151-156. http://dx.doi.org/10.1016/ j.arr. 2012.04.004
[10] Schneider, G. and Heuft, G. (2011) Organisch nicht erklarbare somatoforme Beschwerden und Sturungen im Alter: Ein systematischer Literaturüberblick [Medically unexplained and somatoform complaints and disorders in the elderly: A systematic review of the literature]. Zeitschrift fur Psychosomatische Medizin und Psychotherapie, 57, 1438-3608. http://www.v-r.de/en/magazine_edition-00/zeitschrift_fuer_psychosomatische_medizin_und_psychotherapie_ 2011 _ 57_-1009303/
[11] Sheehan, B. and Banerjee, S. (1999) Review: Somatization in the elderly. International Journal of Geriatric Psychiatry, 14, 1044-1049. http://dx.doi.org/10.1002/(SICI)1099-1166(199912)14:12 <1044::AID-GPS55>3.0. CO;2-0
[12] Wittchen, H.U. (2004) Continued needs for epidemiological studies of mental disorders in the community. Psychotherapy and Psychosomatics, 73, 197-206. http://dx.doi.org/10.1159/000077738
[13] Creed, F. and Barsky, A. (2004) A systematic review of the epidemiology of somatisation disorder and hypochondriasis. Journal of Psychosomatic Research, 56, 391-408. http://dx.doi.org/10.1016/ S0022-3999(03)00622-6
[14] Sharpe, M. and Carson, A.J. (2001) “Unexplained” somatic symptoms, functional syndromes, and somatization: Do we need a paradigm shift? Annals of Internal Medicine, 134, 926-930. http://dx.doi.org/10.7326/ 0003-4819-134-9_Part_2-200105011-00018
[15] Creed, F. (2006) Can DSM-V facilitate productive research into the somatoform disorders? Journal of Psychosomatic Research, 60, 331-334. http://dx.doi.org/10.1016/j.jpsychores.2006.02.007
[16] Janca, A. (2005) Rethinking somatoform disorders. Current Opinion in Psychiatry, 18, 65-71.
[17] Lowe, B., Mundt, M., Herzog, W., Brunner, R., Backenstrass, M., Kronmüller, K., et al. (2008) Validity of current somatoform disorder diagnoses: Perspectives for classification in DSM-V and ICD-11. Psychopathology, 41, 4-9. http://dx.doi.org/10.1159/000109949
[18] Mayou, R., Kirmayer, L.J., Simon, G., Kroenke, K. and Sharpe, M. (2005) Somatoform disorders: Time for a new approach in DSM-V. American Journal of Psychiatry, 162, 847-855. http://dx.doi.org/10. 1176/ appi.ajp.162.5.847
[19] Rief, W. and Hiller, W. (1999) Toward empirically based criteria for the classification of somatoform disorders. Journal of Psychosomatic Research, 46, 507-518. http://dx.doi.org/10.1016/S0022-3999(99)00023-9
[20] Dimsdale, J. and Creed, F. (2009) The proposed diagnosis of somatic symptom disorders in DSM-V to replace somatoform disorders in DSM-IV—A preliminary report. Journal of Psychosomatic Research, 66, 473-476. http://dx.doi.org/10.1016/j.jpsychores.2009.03.005
[21] Stekel, W. (1922) Impulshandlungen, wandertrieb, dipsomanie, kleptomanie, pyromanie und verwandte zustonde: St?rungen des triebund affektlebens. Urban und Schwarzenberg, Berlin.
[22] van Teslaar, J.S. and Stekel, W. (1925) Peculiarities of behavior: Wandering mania, dipsomania, cleptomania, pyromania and allied impulsive acts. William and Norgate, London.
[23] Briquet, P. (1859) Traite de l’hysterie. Bailliere et Fils, Paris.
[24] Charcot, J.M. (1872) Lecon sur le maladies du systeme nerveux faites a la Salpetiere. Delahaye, Paris.
[25] Breuer, J. and Freud, S. (1893) über den psychischen Mechanismus hysterischer Ph?nomene. Vorl?ufige Mitteilung. Neurologisches Centralblatt, 12, 4-10.
[26] APA (1952) Diagnostic and statistical manual of mental disorders. American Psychiatric Association Washington DC.
[27] APA (1968) Diagnostic and statistical manual of mental disorders (2nd Edition) (DSM-II). American Psychiatric Association Washington DC.
[28] APA (1980) Diagnostic and statistical manual of mental disorders (3rd Edition) (DSM-III). American Psychiatric Association, Washington DC.
[29] APA (1994) Diagnostic and statistical manual of mental disorders (4th edition) (DSM-IV). American Psychiatric Association, Washington DC.
[30] Grabe, H.J., Meyer, C., Hapke, U., Rumpf, H., Freyberger, H., Dilling, H., et al. (2003) Specific somatoform disorders in the general population. Psychosomatics, 44, 304-311. http://dx.doi.org/ 10.1176/appi.psy. 44.4.304
[31] Lynch, D.J., McGardy, A., Nagel, R. and Zsembik, C. (1999) Somatization in family practice: Comparing 5 methods of classification. The Primary Care Companion —Journal of Clinical Psychiatry, 1, 85-89. http://dx.doi.org/10.4088/PCC.v01n0305
[32] Roebuck, J. (1979) When does old age begin? Journal of Social History, 12, 16-28. http://dx.doi.org/ 10.1353/jsh/12.3.416
[33] Escobar, J.I., Burnam, M.A., Karno, M., Forsythe, A. and Golding, J.M. (1987) Somatization in the community. Archives of General Psychiatry, 44, 713-718. http://dx.doi.org/10.1001/archpsyc.1987. 01800200039006
[34] Hiller, W., Rief, W. and Braehler, E. (2006) Somatization in the population: From mild body misperceptions to disabling symptoms. Social Psychiatry and Psychiatric Epidemiology, 41, 704-712. http://dx.doi.org/10.1007/s00127-006-0082-y
[35] Wittchen, U., Essau, L.A., Von Zerssen, D., Kreig, J.-C. and Zaudig, M. (1992) Lifetime and six-month prevalence of mental disorders in the Munich follow-up study. Psychiatry and Clinical Neurosciences, 241, 247-258. http://dx.doi.org/10.1007/BF02190261
[36] Frohlich, C., Jacobi, F. and Wittchen, H.U. (2006) DSMIV pain disorder in the general population. An exploration of the structure and threshold of medically unexplained pain symptoms. European Archives of Psychiatry and Clinical Neuroscience, 256, 187-196. http://dx.doi.org/10.1007/s00406-005-0625-3
[37] Pribor, E.F., Smith, D.S. and Yutzy, S.H. (1994) Somatization disorder in elderly patients. The American Journal of Geriatric Psychiatry, 2, 109-117. http://dx.doi.org/10.1097/00019442-199405000-00004
[38] Costa, P.T. and McCrae, R.R. (1980) Somatic complaints in males as a function of age and neuroticism: A longitudinal analysis. Journal of Behavioral Medicine, 3, 245257. http://dx.doi.org/10.1007/BF00845050
[39] Hardy, P. (1995) épidémiologie des troubles somatoformmes dans la population générale francais. L’Encéphale, 21, 191-199.
[40] Larkin, B.A., Copeland, J.R.M., Dewey, M.E., Davidson, I.A., Saunders, P.A. and Sharma, V.K., et al. (1992) The natural history of neurotic disorder in an elderly urban population. The British Journal of Psychiatry, 160, 681-686. http://dx.doi.org/10.1192/bjp.160.5.681
[41] Leikens, K.A., Finset, A., Monum, T. and Sandanger, I. (2007) Current somatoform disorders in Norway: Prevalence, risk factors and comorbidity with anxiety, depresssion and musculoskeletal disorders. Social Psychiatry and Psychiatric Epidemiology, 42, 698-710. http://dx.doi.org/10.1007/ s00127-007-0218-8
[42] Stenback, A., Kumpulainen, M., Vauhkonen, M.-L. (1978) Illness and health behavior in septuagenarians. Journal of Gerontology, 33, 57-61.
[43] de Waal, M.W., Arnold, I.A., Eekhof, J.A. and van Hemert, A.M. (2004) Somatoform disorders in general practice: Prevalence, functional impairment and comorbidity with anxiety and depressive disorders. The British Journal of Psychiatry, 184, 470-476. http://dx.doi.org/10.1192/bjp.184.6.470
[44] Gureje, O., Simon, G.E., Ustun, T.B. and Goldberg, D.P. (1997) Somatization in cross-cultural perspective: A World Health Organization study in primary care. The American Journal of Psychiatry, 154, 989-995.
[45] Kirmayer, L.J. and Robbins, J.M. (1996) Patients who somatize in primary care: A longitudinal study of cognitive and social characteristics. Psychological Medicine, 26, 937-951. http://dx.doi.org/10.1017/ S0033291700035273
[46] Lyness, J.M., Caine, E.D., King, D.A., Cox, C. and Yoediono, Z. (1999) Psychiatric disorders in older primary care patients. Journal of General Internal Medicine, 14, 249-254. http://dx.doi.org/10.1046/ j.1525-1497.1999. 00326.x
[47] Verhaak, P.F., Meijer, S.A., Visser, A.P. and Wolters, G. (2006) Persistent presentation of medically unexplained symptoms in general practice. Family Practice, 23, 414-420. http://dx.doi.org/ 10.1093/fampra/cml016
[48] Leiknes, K.A., Finset, A., Moum, T. and Sandanger, I. (2006) Methodological issues concerning lifetime medically unexplained and medically explained symptoms of the composite international diagnostic interview: A prospective 11-year follow-up study. Journal of Psychosomatic Research, 61, 169-179. http://dx.doi.org/10.1016/j.jpsychores.2006.01.007
[49] Escobar, J.I., Rubio-Stipec, M., Canino, G. and Karno, M. (1989) Somatic symptoms index (SSI): A new and abridged somatization construct. Prevalence and epidemiological correlates in two large community samples. Journal of Nervous & Mental Disease, 177, 140-146. http://dx.doi.org/10.1097/ 00005053-198903000-00003
[50] Escobar, J.I., Cook, B., Chen, C.N., Gara, M.A., Alegria, M. and Interian, A., et al. (2010) Whether medically unexplained or not, three or more concurrent somatic symptoms predict psychopathology and service use in community populations. Journal of Psychosomatic Research, 69, 1-8. http://dx.doi.org/10.1016/j.jpsychores.2010.01.001
[51] Ogden, J. (2003) What do symptoms mean. British Medical Journal, 327, 409-410. http://dx.doi.org/10.1136/ bmj.327.7412.409
[52] Rief, W. and Isaac, M. (2007) Are somatoform disorders “mental disorders”? A contribution to the current debate. Current Opinion in Psychiatry, 20, 143-146. http://dx.doi.org/10.1097/YCO. 0b013e3280346999
[53] Fink, P., Rosendal, M. and Olesen, F. (2005) Classification of somatization and functional somatic symptoms in primary care. Australian & New Zealand Journal of Psychiatry, 39, 772-781. http://dx.doi.org/10.1080/j.1440-1614.2005.01682.x
[54] Sheehan, B., Philpot, M. and Banerjee, S. (2002) Attributions of physical symptoms in patients of an old age psychiatry service. International Journal of Geriatric Psychiatry, 17, 61-64. http://dx.doi.org/10. 1002/ gps.520
[55] Wijeratne, C. and Hickie, I. (2001) Somatic distress symptoms in later life: The need for paradigm change. Psychological Medicine, 31, 571-576. http://dx.doi.org/10.1017/S003329170100383X
[56] Simon, G.E. and Gureje, O. (1999) Stability of somatization disorder and somatization symptoms among primary care patients. Archives of General Psychiatry, 56, 90-95. http://dx.doi.org/10.1001/ archpsyc. 56.1.90
[57] APA. (2012) DSM-5 Development. Proposed Revisions—Somatic Symptom Disorder. http://www.dsm5.org/ ProposedRevision/Pages/proposedrevision. aspx?rid=368#.
[58] Mailis-Gagnon, A., Nicholson, K., Yegneswaran B. and Zurowski, M. (2008) Pain characteristics of adults 65 years of age and older referred to a tertiary care pain clinic. Pain Research & Management, 13, 389-394.
[59] Wijeratne, C., Shome, S., Hickie, I. and Koschera, A. (2001) An age-based comparison of chronic pain clinic patients. International Journal of Geriatric Psychiatry, 16, 477-483. http://dx.doi.org/10. 1002/ gps.366
[60] Voigt, K., Nagel, A., Meyer, B., Langs, G., Braukhaus, C. and Lowe, B. (2010) Towards positive diagnostic criteria: A systematic review of somatoform disorder diagnoses and suggestions for future classification. Journal of Psychosomatic Research, 68, 403-414. http://dx.doi.org/ 10.1016/j.jpsychores. 2010.01.015
[61] Kroenke, K., Spitzer, R., deGruy, F., Hahn, S., Linzer, M. and Williams, J., et al. (1997) Multisomatoform disorder: An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Archives of General Psychiatry, 54, 352-358. http://dx.doi.org/10.1001/ archpsyc.1997. 01830160080011
[62] Rief, W., Heuser, J., Mayrhuber, E., Stelzer, I., Hiller, W. and Fichter, M.M. (1996) The classification of multiple somatoform symptoms. Journal of Nervous & Mental Disease, 184, 680-687. http://dx.doi.org/10. 1097/00005053- 199611000-00005
[63] Rubio, G. and Lopez-Ibor, J. (2007) Generalized anxiety disorder: A 40-year follow-up study. Acta Psychiatrica Scandinavica, 115, 372-379. http://dx.doi.org/10.1111/j.1600-0447.2006.00896.x
[64] Sheikh, J.I., Swales, P.J., King, R.J., Sazima, G.C. and Bail, G. (1999) Somatization in young versus older female panic disorder patients. International Journal of Geriatric Psychiatry, 13, 564-567. http://dx.doi.org/10.1002/(SICI)1099-1166(199808)13:8<564::AID-GPS817>3.0.CO;2-4
[65] Drayer, R.A., Mulsant, B.H., Lenze, E.J., Rollman, B.L., Dew, M.A. and Kelleher, K., et al. (2005) Somatic symptoms of depression in elderly patients with medical comorbidities. International Journal of Geriatric Psychiatry, 20, 973-982. http://dx.doi.org/10.1002/gps.1389
[66] Hilderink, P.H., Benraad, C.E.M., van Driel, D., Buitelaar, J.K., Speckens, A.E.M. and Rikkert, M.G.M.O., et al. (2009) Medically unexplained physical symptoms in elderly people: A pilot study of psychiatric geriatric characteristics. The American Journal of Geriatric Psychiatry, 17, 1085-1088. http://dx.doi.org/10.1097/JGP. 0b013e3181b975a1
[67] Shahpesandy, H. (2005) Different manifestation of depressive disorder in the elderly. Neuroendocrinology Letters, 26, 691-695. http://www.nel.edu/home.htm.
[68] Yu, D.S.F. and Lee, D.T.F. (2012) Do medically unexplained somatic symptoms predict depression in older Chinese? International Journal of Geriatric Psychiatry, 27, 119-126. http://dx.doi.org/10. 1002/gps. 2692

  
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