Psychiatry Research EG

Somatoform ‘somatization’ disorder is a widespread phenomenon across different cultures and healthcare systems. In patients with somatoform disorders (SD), emotional distress or difficult life situations are experienced as physical symptoms [1]. Individuals with somatization perceive themselves as sick and physically disabled [2]. The help-seeking behavior of persons with somatization symptoms may be difficult for physicians to understand [2,3]. Failure to identify this condition and to manage it properly may lead to frustrating, costly, and potentially dangerous interventions that generally fail to identify occult disease and do not reduce suffering [1]. Patients with unexplainable somatic symptoms usually have a disturbed sleep pattern [4]. Plante et al. [5] reported that the current formulation of SDs within psychiatry is limited because it does not acknowledge the central role of sleep disturbance that is common for all of these disorders. What is the cause of sleep disturbance in patients with SD? Is it related to associated anxiety symptoms or depressive symptoms or both, or is it the result of alexithymia usually found in such patients? Can pain also be a factor? Is sleep disturbance genuine for patients with SD? Or are all of the above factors relevant for patients with SD? In this research, we attempt to answer these questions by exploring the sleep profile of patients with SD. In this research, we chose to compare the sleep profile of somatization patients with that of major depressive disorder (MDD) patients, because of the following reasons. Sleep in depression has been investigated in more detail than that for any other psychiatric disorder, although no findings have not been pathogonomic [6]. Somatization is a frequently mentioned feature of depression in patients seen by primary care physicians [7], and patients with somatization usually present with some depressive features and sometimes develop full-blown picture of MDDs. Finally alexithymia is a commonconstruct usually encountered in both disorders, with some evidence that it has an effect on the sleep profile of patients [8]. In terms of the sleep profile of MDD patients, approximately two-thirds of patients with MDD have some type of insomnia; of these, nearly 40% complain of specific symptoms with sleep onset difficulty, frequent awakenings, and early morning insomnia [9]. The insomnia complaints of patients with depression can be more severe than those of patients with primary insomnia (i.e. insomnia related to behavioral and conditioning factors). Approximately 15% of depressed patients complain of hypersomnia [10]. The sleep profile of patients with depression has the following characteristics: slow wave sleep (SWS) deficiency, decreased sleep duration (caused by the increased sleep latency, awakenings during the night, and early morning awakenings), redistribution of rapid eye movement (REM) sleep with its concentration in the first half of the night, decreased REM sleep latency, increased eye movement density in the first cycle, and absence of the first night effect [6]. Although none of the abovementioned alterations in the sleep profile is specific for depression, their combination displays a pattern that is mostly typical for depressed patients [11]. Previous researchers have attempted to find a biological link between MDD and SD, for example, the study of Rief et al. [12] aimed to examine possible immunological differences between patients with major depression, somatization, and healthy controls. Our research represents a second step with the same aim, but uses a different biological marker, which is the sleep profile of these patients