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Somatization disorder in a US Southern community: use of a new procedure for analysis of medical classification

Published online by Cambridge University Press:  09 July 2009

Marvin Swartz ,
Dan Blazer ,
Max Woodbury ,
Linda George  and
Richard Landerman
Marvin Swartz*
Affiliation:
Department of Psychiatry, Division of Social and Community Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
Dan Blazer
Affiliation:
Department of Psychiatry, Division of Social and Community Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
Max Woodbury
Affiliation:
Department of Psychiatry, Division of Social and Community Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
Linda George
Affiliation:
Department of Psychiatry, Division of Social and Community Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
Richard Landerman
Affiliation:
Department of Psychiatry, Division of Social and Community Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
*
1Address for correspondence: Dr Marvin Swartz, Department of Psychiatry, Division of Social and Community Psychiatry, Duke University Medical Center, P.O. Box 3173, Durham, North Carolina 27710, USA
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Synopsis

The authors examine somatization disorder in a community population, using grade of membership analysis, a new multivariate analytical technique for the analysis of medical classification. The technique is used to examine whether somatic symptoms will cluster into a clinical syndrome resembling somatization disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), if no a priori assumptions are made about the interrelationship of somatic symptoms or their clustering into clinical syndromes. Grade of membershp analysis is applied to all respondents in the US National Institute of Mental Health Epidemiological Catchment Area Project of the Piedmont region of North Carolina reporting three of more somatic symptoms from the somatization disorder section of the Dagnostic Interview Schedule. The analysis indicates that seven ‘pure’ types, roughly analogous to clusters in cluster analysis, best describe the interrelationship of the symptoms included in the analysis. One ‘pure’ type in the analysis is nearly identical to DSM-III somatization disorder and is associated with demographic characteristics consistently found among patients with DSM-III somatization disorder. The present results demonstrate that symptoms associated with this disorder do cluster in a highly predictable fashion and represent a strong validation of the natural occurrence of an entity resembling somatization disorder.

Type
Research Article
Information
Psychological Medicine , Volume 16 , Issue 3 , August 1986 , pp. 595 - 609
Copyright
Copyright © Cambridge University Press 1986

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References

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (DSM-III) (3rd edn). APA: Washington; D.C.Google Scholar
Blazer, D. G., George, L. K., Landerman, R., Pennybacker, M. R., Melville, M. L., Woodbury, M. A., Manton, K. G., Jordan, K. & Locke, B. Z. (1985). Psychiatric disorders: a rural/urban comparison. Archives of General Psychiatry 42, 651–656.Google Scholar
Cloninger, R. L., Sigvardsson, S., von, Knorring A. L. & Bohman, M. (1984). An adoption study of somatoform disorders: II. Identification of two discrete somatoform disorders. Archives of General Psychiatry 41, 863–871.CrossRefGoogle ScholarPubMed
Coryell, N. (1981). Diagnosis-specific mortality: primary unipolar depression and Briquet's syndrome (somatization disorder). Archives of General Psychiatry 38, 939–942.Google Scholar
Goodwin, D. W. & Guze, S. B. (1979). Psychiatric Diagnosis (2nd edn). Oxford University Press: New York.Google Scholar
Guze, S. B. (1975). The validity and significance of the clinical diagnosis of hysteria (Briquet's syndrome). American Journal of Psychiatry 132, 138–141.Google Scholar
Guze, S. B. & Perley, M. J. (1963). Observations on natural history of hysteria. American Journal of Psychiatry 124, 491–498.Google Scholar
Kaplan, H. I. & Sadock, B. J. (1981). Modern Synopsis of Comprehensive Textbook of Psychiatry, Vol. 3 (3rd edn). Williams & Wilkins: Baltimore.Google Scholar
Kish, L. (1965). Survey Sampling. John Wiley & Sons: New York.Google Scholar
Perley, M. J. & Guze, S. B. (1962). Hysteria – the Stability and usefulness of clinical criteria. New England Journal of Medicine 266, 421–426.Google Scholar
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule. Archives of General Psychiatry 38, 381–392.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry 35, 773–782.Google Scholar
Strauss, J. S., Gabriel, K. R., Kokes, R. I., Ritzler, B. A., Van Ord, A. & Tarama, E. (1979). Do psychiatric patients fit their diagnosis? Patterns of symptomatology as described with the biplot. Journal of Nervous and Mental Disease 167, 105–112.Google Scholar
Swartz, M. S., Blazer, D. G., George, L. K. & Landerman, R. (1986). Somatization disorder in a community population. (Submitted for publication.)Google Scholar
Weissman, M. M., Myers, J. K. & Harding, P. S. (1978). Psychiatric disorders in a US urban community: 1975–1976. American Journal of Psychiatry 135, 459–462.Google Scholar
Woodbury, M. A. & Manton, K. G. (1982). A new procedure for analysis of medical classification. Methods of Information in Medicine 21, 210–220.Google Scholar