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Searching for a Gastrointestinal Subgroup Within the Somatoform Disorders

Received December 16, 1999; revised April 5, 2000; accepted June 28, 2000. From the Roseneck Center of Behavioral Medicine, Prien, Germany, and the Psychological Institute of the University of Mainz, Germany. Address correspondence and reprint requests to Dr. Hiller, University of Mainz, Psychological Institute, Staudingerweg 9, D-55099 Mainz, Germany; e-mail: hiller{at}mail.uni-mainz.de

The authors examined whether patients suffering from functional gastrointestinal symptoms constitute a separate group within the broader concept of the somatoform disorders. The authors compared 103 patients with a severe gastrointestinal syndrome, 220 patients with a somatization syndrome according to DSM-IV, and 250 clinical control subjects with nonsomatoform mental disorders. The gastrointestinal group showed more catastrophizing thinking, complained more about autonomic sensations, felt bodily weaker, was less tolerant towards bodily discomfort, had developed more hypochondriacal fears and behaviors, was more depressed, and was more severely disabled in different areas of psychosocial functioning than the other groups. These differences, however, disappeared when general somatization was controlled for by analysis of covariance. Only a small effect related to dysfunctional cognitions remained specific to the gastrointestinal syndrome. Because these results do not confirm the idea of an independent gastrointestinal syndrome, general mechanisms of somatization seem to play the dominant role.

Key Words: Somatoform Disorders • gastrointestinal symptoms • hypochondriasis

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