Int J Clin Exp Med 2016;9(9):18564-18568

www.ijcem.com /ISSN:1940-
5901/IJCEM0026387

Original Article Psychological status and

coping strategy of somatization disorders

Haijie Zhang, Zhihua Zhang, Danning

Zhang

Shandong Mental Health Center, Jinan, P. R.

China

Received February 22, 2016; Accepted June 4, 2016; Epub September 15, 2016; Published September 30,
2016

Abstract: Objective: To evaluate the psychological status of patients with somatization disorders by using
question- naire survey and professional mental scale, aiming to provide effective coping strategies for
psychological and physical recovery. Methods: Fifty patients diagnosed with somatization disorder and 50
corresponding family mem- bers were assigned into the study group. Fifty healthy subjects and 50 their family
members were allocated into the control group. All participants received comprensive evaluation by using
SCL-90, SSRS and CSQ. Results: In the study group, the average scores of a majority of items in the SAS
and SDS were significantly higher than those in the control group (all P<0.05). The mean scores of overall
social and subjective support in patients with somatization disorder were considerably lower than those in their
counterparts (all P<0.05). In the study group, the average score of negative factor was significantly higher
whereas that of the positive factor was apparently lower compared with the values obtained in the control
group (all P<0.05). Conclusion: Patients diagnosed with somatization disorder and their family members
present with evident psychological symptoms, lack of social support and effective strat- egy against the
symptoms of somatization disorder.

Keywords: Somatization disorder, psychological health,

strategy
devel- opments and advancements have
been accom- plished in terms of somatization
Introductio
disorder, which is among the most
n
challenging of psychiatric disorders
encountered in clinical experiences. Multiple
Somatization disorder, also known as
diagnostic criteria have been revised to
Briquet’s syndrome, is defined as a mental
facilitate the clinical diagnosis and corre-
disorder clini- cally characterized by
sponding strategy. At present, differential
recurring, multiple and clinically significant
diag- nostic tools mainly include neurologic
complaints about somatic symptoms [1-3]. It
disor- ders, systemic medical disorders, and
has been recognized in the DSM-IV-TR
alter- native psychiatric disorders, such as
classification scale, which is com- bined with
mental anxiety disorders, conversion
undifferentiated somatoform disor- der to
disorder, malin- gering, and factitious
become somatic symptom disorder in the
disorder, etc. Previous
latest version DSM-5, in which the diagnos-
studies have reported that a large proportion
tic criteria does not require a specific number
of patients present with more than one of
of somatic symptoms [4-7]. Multiple novel
such ill- nesses complicated with between the patients and their family
somatization disorder [8-11]. In clinical members in terms of mental and psycho-
practice, somatization disor- der requires logical issues. In this study, multiple
comprehensive and novel psycho- social evaluation scales have been utilized to
treatment designed by the professional assess the mental and psychological status,
neurologists and psychiatrists and alternative explore the major problems and identify
mental experts. effective interventional strategies to radically
resolve these issues from both social and
However, most previous investigations family perspectives, which probably elevate
mainly focus upon evaluating the mental the mental recovery and qual- ity of life of
status of patients diagnosed with patients suffering from somatiza- tion
somatization disorder. Few studies have disorder.
been reported to assess the discrepancy
Psychological status and coping strategy of somatization disorders
Materials and methods
Study subjects
In total, 50 patients diagnosed with somatiza- tion disorder admitted to XXX hospital between September 2014 and Octobe
family members (n=50) were recruited into the study group. All patients were diagnosed acc- ording to International Statistic
of Diseases and Related Health Problems [xxx] (ICD-10).
Among 50 patients, there were 13 males and 37 females, aged from 16 to 73 years, with mean age 43.8 ± 10.7 years. Twe
educational level of elementary school or below, 25 with junior middle school, 9 with spe- cialized middle school or senior
4 with college or university background or above. Adult family members who could under- stand the survey contents, norm
without severe physical or psychological diseases or systemic illnesses were eligible for subsequent analysis. Seven pairs
were spouses, 11 were mother-and-son relationship, 12 were mother-and-daughter relationship, 6 were father-and-daught
6 were father-and-son relationship, 5 were brother or sister relationship and 3 were mother and daughter-in-law relationshi
In the control group, 50 normal controls were all staff from XXX hospital. Meantime, 50 family members of these 50 control
also enrolled in this study. Adult family mem- bers who were able to comprehend the survey contents, with normal ment
severe physical or psychological diseases or systemic illnesses were eligible for subsequent survey.
Among 50 healthy controls, there were 14 males and 36 females, aged from 16 to 71 years, with mean age 41.4 ± 10.3
educational level of elementary school or below, 17 with junior middle school, 19 with specialized middle school or senior hi
with college or university educational lev- els or above. Ten pairs of participants were spouses, 12 were mother-and-son
were mother-and-daughter relationship, 5 were father-and-daughter relationship, 5 were father-and-son relationship, 6 were
relationship and 2 were mother and daughter-in-law relationship.
18565 Int J Clin Exp Med 2016;9(9):18564-18568 The gender, age, educational background and patient-family member re
totally matched with no statistical significance bet- ween the study and control groups (all P>0.05).
Survey questionnaire
Symptom checklist-90 scale: The Symptom Ch- ecklist-90-R (SCL-90-R) is a relatively brief psy- chometric instrument self
patients. SCL-90 is specially designed for indi- viduals aged 13 years and older, which consists of 90 items and takes 1
accom- plish all questions, generating 9 scores along primary symptom dimensions and 3 scores among global distress i
symp- tom dimensions that are assessed include somatization, obsessive-compulsive, interper- sonal sensitivity, depr
hostility, phobic anxiety, paranoid ideation, psychoti- cism, and a category of “additional items” whi- ch assists the physicia
evalu- ate alternative perspectives of the symptoms of enrolled patients.
Social support rating scale: Social support rat- ing scale (SSRS) is composed of 10 items which are divided into objective sup
support and social support covering three dimensions in total. The questionnaire consists of problems and difficulties ba
logical stress of patients and multiple choices according to the sources of social support.
Coping style questionnaire: Coping style ques- tionnaire (CSQ) includes 62 items which are classified into 6 subscales, s
resolving, self-complain, seeking help, fantasy, escape and rationalization. The score scale ranges from 0 or 1 system. T
questionnaire (TCSQ) and simplified coping style questionnaire (SCSQ) were adopted to assess the negative and posit
tegies.
Results
Comparisons of SCL-90 scores between the study and control groups
As illustrated in Table 1, the mean scores of 8 items in patients diagnosed with somatization disorder and their family memb
cantly higher than those values in the healthy counterparts (all P<0.05). However, the mean score of hostility item did not s
between two groups (P>0.05).
Psychological status and coping strategy of somatization disorders
Table 1. Comparison of SCL-90 scores between the study and control groups
Study group (n=50) Control group (n=50) P Patient Family member Healthy subject Family member Somatization disorder 2.93 ± 0.71 1
0.67 1.37 ± 0.48 <0.05 Obsessive-compulsive 2.91 ± 0.89 1.97 ± 0.43 1.67 ± 0.56 1.68 ± 0.53 <0.05 Interpersonal sensitivity 2.21 ± 0.77
± 0.80 1.65 ± 0.62 <0.05 Anxiety 2.49 ± 0.60 2.28 ± 0.43 1.42 ± 0.56 1.35 ± 0.39 <0.05 Depression 2.80 ± 0.67 1.83 ± 0.62 1.49 ± 0.77
Hostility 2.16 ± 0.56 1.52 ± 0.44 1.98 ± 0.69 1.48 ± 0.48 >0.05 Phobia 1.70 ± 0.82 1.64 ± 0.56 1.27 ± 0.68 1.25 ± 0.51 <0.05 Parano
0.56 1.80 ± 0.55 1.43 ± 0.67 1.42 ± 0.63 <0.05 Psychoticism 1.89 ± 0.49 1.32 ± 0.50 1.28 ± 0.55
Table 2. Comparison of SSRS scores between the study
Discussion and control groups
Study group
Control (n=50)
P
group (n=50) Total score 34.60 ± 7.89 38.96 ± 7.21 <0.05 Objective support score 9.12 ± 4.83 7.63 ± 5.37 >0.05
The results in this study indicated that patients diagnosed with somatization disorder constantly suffer from psy- cholo
Patients with somatization disorder suffer from Subjective support score 18.73 ± 5.34 2
severe financial challenge to the Availability 9.25 ± 3.36 9.54 ± 3.35 >0.05
health service due to the fact that symptoms are often intractable and
Table 3. Comparison of CSQ scores between the study and control groups
require long-term care. During hospi- talization, the physicians and nurses place much attention to the patie
Control group (n=50)
P
(n=50)
whereas neglect the education to- wards the family members of the Positive coping style score 24.34 ± 7.85 3
patients, which may negatively affects Negative coping style score 34.45 ± 5.7 24.86 ± 6.13 <0.05
the recovery of the quality of life of patients.
Comparisons of SSRS scores between the study and control groups
As revealed in Table 2, the total score and sub- jective support score in the study groups were significantly lower comp
values in the control group (both P<0.05). However, the objective support score and the availability score did not considerabl
the study and control groups (both P>0.05).
Comparisons of CSQ scores between the study and control groups
As illustrated in Table 3, the mean score of pos- itive coping style in the study group was signifi- cantly lower than that in th
(P<0.05), whereas the average score of nega- tive coping style in the study group was consid- erably higher than that in th
(P<0.05).
18566 Int J Clin Exp Med 2016;9(9):18564-18568 Through administering questionnaire, the true psychological status
acknowl- edged by the medical staff under the prerequi- site of eliminating the anxiety emotion and obtaining mutual trust b
and physicians. If the patients were unable to com- plete the survey independently, relevant nurses should provide certa
help them to accomplish the task.
Upon admission, the nurses were responsible for explaining the specialized knowledge regard- ing somatization to the pati
channels, such as online chat tool, Weibo blog and alternative online platforms. Furthermore, the patients were informed ab
sis, treatment strategy and process. Such assistance could not only make the patients better understand somatization di
increase their confidence in the treatment and recovery.
Psychological status and coping strategy of somatization disorders
Besides the patients themselves, their family
Address correspondence to: Danning Zhang, Shan- members are likely to suffer from emotional
dong Mental Health Center, 49 Wen Hua Dong Road, problems due to high medical cost and long-
Jinan 250014, P. R. China. E-mail: [email protected] term taking care of the patients. These eco- nomic and psychological burd
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guidance to the family mem-
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