Aus vier mach zwei

Background

The diagnostic and statistical manual of mental disorders 5 (DSM-5) includes a revision of the DSM-IV criteria for somatoform disorders. The aim of the current work was to investigate whether (a) patients with DSM-IV diagnoses of somatization disorder, pain disorder and hypochondriasis and (b) whether patients categorized as having the DSM-5 somatic symptom disorder and illness anxiety disorder differ with respect to illness anxiety and cognition regarding somatic symptoms.

Material and methods

The data from 269 inpatients from the psychosomatic clinic Schön Klinik Bad Bramstedt were used. Somatoform disorders were diagnosed using the German version of the structured clinical interview for DSM-IV (SCID).

Results

Patients with a DSM-IV diagnosis of hypochondriasis differed in illness anxiety and catastrophizing interpretation of somatic symptoms compared to patients with other somatoform disorders. Patients with illness anxiety disorder differed in the catastrophizing interpretation of physical symptoms, autonomic sensations, bodily weakness and intolerance of physical complaints compared to patients with somatic symptom disorder.

Conclusion

The present results indicate that illness anxiety and a catastrophizing interpretation of somatic symptoms play a fundamental role in patients with somatoform disorders. Therefore, psychotherapy should address illness anxiety and health-related concerns in all patients with somatoform disorders.