Elsevier

General Hospital Psychiatry

Volume 14, Issue 5, September 1992, Pages 322-326
General Hospital Psychiatry

The comorbidity of DSM-III-R personality disorders in somatization disorder

https://doi.org/10.1016/0163-8343(92)90066-JGet rights and content

Abstract

In order to understand psychiatric factors that complicate the medical management of somatizing patients, 94 subjects with known somatization disorder (SD) were evaluated for 13 personality disorders with the Structured Clinical Interview for DSM-III-R Personality Disorders. Referred from multiple primary care settings, the patient sample was predominantly female (85%), married (67%), high school graduates (64%), and had a mean age of 43. Structured interviews documented that 23.4% of SD patients had one personality disorder, and 37.2% had two or more disorders. The four most frequently identified personality disorders were avoidance 26.7%, paranoia 21.3%, self-defeating 19.1%, and obsessive-compulsive 17.1%. Interestingly histrionic personality disorder was identified in only 12.8% of the sample and antisocial personality disorder in 7.4%. In making the diagnosis of SD, health care providers need to avoid the common clinical impression that histrionic behavior often accompanies the disorder. Further research with SD patients is needed to examine the relationship of co-occurring personality disorders to symptom recurrence, health care utilization, and readiness for psychiatric referral.

References (23)

  • FW Brown et al.

    Psychiatric comorbidity in primary care somatization disorder

    Psychosom Med

    (1990)
  • B Liskow et al.

    Is Briquet's syndrome a heterogeneous disorder?

    Am J Psychiatry

    (1986)
  • B Liskow et al.

    Inpatients with Briquet's syndrome: presence of additional psychiatric syndromes and MMPI results

    Compr Psychiatry

    (1986)
  • M Swartz et al.

    Somatization disorder

  • R Kimble et al.

    A comparison of two methods of diagnosing hysteria

    Am J Psychiatry

    (1975)
  • SO Lilienfeld et al.

    The relationship of histrionic personality disorder to antisocial personality and somatization disorders

    Am J Psychiatry

    (1986)
  • J Morrison

    Histrionic personality disorder in women with somatization disorder

    Psychosomatics

    (1989)
  • HW Koenigsburg et al.

    The relationship between syndrome and personality disorder in DSM-III: experience with 2462 patients

    Am J Psychiatry

    (1985)
  • CR Cloninger

    The link between hysteria and sociopathy: an integrative model of pathogenesis based on clinical, genetic, and neurophysiological observations

  • CR Cloninger et al.

    Female criminals: their personal, familial, and social backgrounds. The relation of these to the diagnoses of sociopathy and hysteria

    Arch Gen Psychiatry

    (1970)
  • CR Cloninger et al.

    A prospective follow-up and family study of somatization in men and women

    Am J Psychiatry

    (1986)
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    This work was supported in part by grants from the Robert Wood Johnson Foundation 12142, from National Institute of Mental Health R01 MH 41587 and P50 MH 48197, and from the VA HSR&D Field Program for Mental Health.

    1

    Dr. Smith is supported by a Research Scientist Development Award K02MH-00843-01 from the National Institute of Mental Health.

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