2007 Volume 47 Issue 11 Pages 947-954
Objective, Methods: The purpose of this study was to clarify the clinical features of outpatients diagnosed as Somatoform Disorder (SFD) (F45) by ICD-10. In a retrospective study, 130 outpatients with SFD, who visited the psychosomatic outpatient clinic at a university hospital between January 2001 and December 2002, were examined through medical records on subtype diagnosis, trigger, modalities of treatment, and clinical outcome. Results: 1) Fifty nine (45.4%) were diagnosed as undifferentiated somatoform disorder, and 19 (14.6%) autonomic dysfunction. 2) The major trigger was interpersonal conflict (38, 32.8%), unclear (30, 25.9%), physical illness (21, 18.1%) and cumulative occupational fatigue (18, 15.5%) 3) Among the medicated patients, 57 (68.7%) of them were prescribed only anxiolytics and 11 (13.3%) anxiolytics and antidepressants. Concerning psychotherapy, 90 (77.6%) of the patients received only supportive psychotherapy, and 17 (14.7%) combined the intervention of environmental stressors. 4) The outcome was as follows: Thirty-two (24.6%) had dropped out after first consulting, 54 (41.5%) of the patients were unchanged, and 30 (23.1 %) showed improvement in symptoms. The percentage of "unclear" in the group drop-outs after first consulting is the highest of the three outcomes. The patients who were unchanged followed two clinical courses. Patients in one group stopped the treatment in short term, while patients in another continued in long term. The latter had improvements soon after first consulting, but they could not maintain those conditions. The major triggers in patients who showed improvement were 'cumulative occupational fatigue' and 'interpersonal conflict'. Conclusion: There is some sort of relationship between patients with obvious trigger and outcome. It seems that they could easily understand mind-body correlation and are expected to continue the psychosomatic treatment. It is important for unchanged patients to have improvement once soon after first consulting. Most of the patients had improvement soon after first consulting, while some patients required more than three months until their symptoms improved.
