The utility of the Psychosomatic Symptom Checklist among hospitalized patients

Impact of functional gastrointestinal disorders on health-related quality of life: a population-based case-control study

BACKGROUND

The health-related quality of life is impaired in patients with functional gastrointestinal disorders seen in referral centres.

AIM

To determine whether the health-related quality of life is impaired in subjects with functional disorders in the community and whether any differences can be explained by psychological co-morbidity.

METHODS

In a population-based, nested, case-control study, subjects reporting symptoms of either dyspepsia or irritable bowel syndrome and healthy controls were interviewed and completed a battery of psychological measures plus a validated, generic, health-related quality of life measure (Medical Outcomes Study 36-item short form health survey, SF-36). The association between irritable bowel syndrome and dyspepsia and the physical and mental composite scores of SF-36 were assessed with and without adjustment for psychological state.

RESULTS

One hundred and twelve cases (30 dyspepsia, 39 irritable bowel syndrome, 32 dyspepsia and irritable bowel syndrome and 11 gastrointestinal symptoms but not dyspepsia or irritable bowel syndrome) and 110 controls were enrolled. In the unadjusted linear regression models, irritable bowel syndrome (but not dyspepsia) was negatively associated with the physical composite score (P < 0.05); in an adjusted model, the association between the physical health-related quality of life and irritable bowel syndrome was explained by the Symptom Checklist-90 somatization score alone. In unadjusted models, irritable bowel syndrome and dyspepsia were each negatively associated with the mental composite score (P < 0.05). The association between the mental health-related quality of life and dyspepsia remained after adjusting for psychological covariates, but the association between this and irritable bowel syndrome was not significant after adjustment.

CONCLUSIONS

In the community, health-related quality of life is impaired in subjects with irritable bowel syndrome and dyspepsia; however, much of this association can be explained by psychological factors.

Medical Acupuncture and the Management of Psychosomatic Illness

Acupuncture is an intensive and holistic therapy that enhances the quality of life of psychosomatic patients. It helps to slow or reverse the process whereby anxiety, depression and other forms of psychological distress are transformed into physical symptomatology. This process, termed “somatisation”, is little understood in Western medicine, although it is implicated in many of the cases seen in general medical practice. Traditional Chinese medicine provides an explanation of how endogenous factors encompassing negative emotions and psychosocial stress can generate illness. This paper specifies acupuncture points and procedures to be used in managing general psychosomatic illness, as well as controlling the severe distress experienced by some psychosomatic patients.