شباهتها و تفاوت بین دو گروه تشخیصی: اختلالات شبه جسمی کنونی، اضطراب و / یا افسردگی و اختلالات اسکلتی عضلانی

Objective To identify the similarities and differences of risk factors and correlates of different groups of people fulfilling criteria for specified diagnostic groups according to current somatoform disorder (SDs) criteria, presence of anxiety and/or depression, and self-reported musculoskeletal disorders. Methods Participants of the Oslo–Lofoten general population cross-sectional study in 2000–2001 interviewed with the Composite International Diagnostic Interview (CIDI) somatoform section were examined by comparing similarities and differences in 8 groups identified by cross-tabulation of current SDs, anxiety and/or depression, and musculoskeletal disorders. The current SDs group was computed from the CIDI somatoform section raw data, anxiety and/or depression from the CIDI diagnostic algorithms and musculoskeletal disorders by questionnaire and self evaluation. Results In the 2001 sample of 1668 (875 women and 793 men) participants, the following eight disorder groups were identified: (i) current SDs, n=49 (75.5% women) (ii) musculoskeletal (functional somatic disorders), n=327; (53.5% women) (iii) anxiety and/or depression, n=148 (73.6% women); (iv) current SDs with anxiety and/or depression, n=38 (73.7% women); (v) current SDs with musculoskeletal, n=44 (72.7% women); (vi) current SDs with anxiety and/or depression and musculoskeletal, n=34 (76.5% women); (vii) musculoskeletal with anxiety and/or depression, n=101 (66.3% women); and (viii) no disorders, n=927 (43.3% women). Commonalities and differences between current SDs, anxiety and/or depression, and musculoskeletal disorders are apparent. Impairment of outcomes and risk factor load is high in current SDs with anxiety and/or depression and musculoskeletal. Conclusion The data in this article could help toward the needed DSM-V and ICD-11 diagnostic revision of the SDs category.

The identification of medically explained (MES) and unexplained (MUS) symptoms, as required by existing DSM-IV [1] and ICD-10 [2] classification of somatoform disorders (SDs), has been found prone to faulty recall over time [3] and a large degree of overlap between existing somatoform diagnostic categories has been demonstrated [4]. It has been postulated that one cannot justify considering SDs alone (with no psychiatric disorder co-morbidity) a mental disorder [5]. The critique of today's SDs classification systems is extensive [5], [6], [7], [8], [9], [10] and [11] and voices advocating the need for revision in the forthcoming DSM-V and ICD-11 revisions are many [7], [12], [13], [14], [15], [16], [17], [18] and [19]. The data in this article could help towards that revision. Essential to the revision is knowledge about commonalities and differences in risk factors, mental state and outcome measures between SDs and functional somatic syndromes (FSS) diagnosis groups from general population studies. In contrast to other recent epidemiological studies [20] and [21] the Oslo–Lofoten survey [4], [5] and [22] included and did not leave out, the SDs section in the Composite International Diagnostic Interview (CIDI) [23]. Against this background, the aim of this article is to explore common and specific aspects of SDs and FSS diagnostic categories, derived from the cross-tabulation of current SDs, anxiety and/or depression, and musculoskeletal disorders in all participants interviewed with the CIDI somatoform section in the Oslo–Lofoten 2000–2001 (hereafter 2001) cross-sectional study. We hypothesize that the risk factor load and the impairment of outcomes (meaning the overall amount of statistically significant (P<.05) variables) would be greatest in people with a combination of current SDs with anxiety and/or depression and/or musculoskeletal. We expect the risk factor load to be smaller in those with current SD and musculoskeletal disorders and least in those without disorders

Current SDs are similar to, but in some respects also different from, musculoskeletal disorders on one hand and anxiety and/or depression disorders on the other. The data in this article could help toward the DSM-V and ICD-11 diagnostic revision of the SDs category.