Psychopathologische profielen bij patiënten met een ernstige somatoforme stoornis – En de rol van acceptatie en hulpeloosheid

Abstract

Severe somatoform disorders are characterized by a chronic disease course and prevalent comorbid disorders. Patients are often highly distressed and treatment is not consistently effective. This cross-sectional study aims to contribute to the body of research on treatment indications. The study examined the association between psychopathological profiles based on DSM-IV-TR classifications and health status in patients with a severe somatoform disorder, as well as the moderating role of acceptance and helplessness. Data of 322 patients (99 men and 223 women, mean age 44 years) during the diagnostic phase at Altrecht Psychosomatiek Eikenboom were retrieved from clinical files. Health status was assessed with four variables: general physical functioning, general mental functioning, physical symptoms, and frequency of daily activities. The results indicated that both comorbid clinical disorders and comorbid psychosocial problems were associated with a decrease in patients’ health status. Acceptance was associated with better mental functioning but reduced physical functioning. Furthermore, it was tentatively indicated that acceptance buffered the negative effects of comorbid psychopathology. Helplessness was associated with an overall decreased health status. However, the expected interaction between helplessness and comorbid psychopathology was not confirmed. These cross-sectional findings will feed outcome research. If psychopathological profiles in combination with acceptance and helplessness predict therapy outcome, this may lead to an improvement of the indication for and customization of treatment of the individual with a severe somatoform disorder.