Research view


Title: A study of personality disorders among patients with somatization disorder
Author: Hiam F. Elsaied, Rania A. Hamed and Yared Belay
Background The fact that there is a high association between personality disorders (PDs) and somatization disorder (SD) is widely accepted, to the extent that many expert clinicians find themselves compelled to manage personality traits in patients with SD to obtain good treatment outcomes. This study was conducted to identify the distribution of all Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision (DSM-IV-TR) PDs among patients with SD who were referred from primary care settings. Patients and methods This case–control study was conducted from September 2014 to April 2015 and was approved by the Ethics Committee at Al Amal Psychiatric Hospital, in Almadina Almonawara, KSA. Demographic data including sex, age, marital status, and education level of the cases and controls were collected. SD was diagnosed according to the DSM-IV-TR, whereas PDs were measured using the Diagnostic Checklist for Personality Disorders. Results The ages of cases ranged from 32 to 50 years (mean: 39.21±6.45 years); 55.8% of the group was male and 67.3% was married; 924.2% of the participants were educated. There was no significant difference in sociodemographic characteristics. The incidence of PDs in SD patients was 63.3%, compared with 10% in controls [odds ratio (OR)=18.5294; 95% confidence interval (95% CI)=5.6686–60.5687]. The highest OR for PDs in patients with SD, compared with that in controls, was for paranoid personality (OR=18.2063; 95% CI=4.9595–66.8357), followed by obsessive personality (OR=16.5000; 95% CI=5.8373–46.6399), and histrionic personality (OR=9.0444; 95% CI=2.4677–33.1489). Conclusion PDs in Saudi SD patients is very high. The results were comparable to that found in British and American studies, supporting the theory of Lillienfield that SD should be grouped under Axis II disorders of the DSM system and not under Axis I. Paranoid, obsessive, and histrionic personalities were the most common PD subtypes in SD patients as regards ORs. Keywords: Diagnostic and Statistical Manual of Mental Disorders, 3rd ed, revision, somatization disorders, personality disorder schedule, personality disorders
Distributor: Egypt J Psychiatr 38:138–142