신체증상장애의 정신사회적 특성 및 관련 요인: 단면 연구

초록

Objective: This study aimed to explore the clinical characteristics of patients with somatic symptom disorder and to evaluate the clinical factors influencing its diagnosis. Methods: Data were collected from outpatients at the Department of Psychiatry at a tertiary medical center, between November 2021 and November 2024. Patients were diagnosed with somatic symptom disorder by a psychiatrist based on DSM-5 criteria. The following instruments were used: Somatic Symptom Disorder-B Criteria Scale (SSD-12), Patient Health Questionnaire-15 (PHQ-15), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7), Toronto Alexithymia Scale (TAS), Visual Analogue Scale (VAS), Duke-UNC Functional Social Support Questionnaire (DUFSS), Cumulative Illness Rating Scale (CIRS), EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), and World Health Organization Quality of Life Brief Version (WHOQOL-BREF). Results: Of the 242 participants, 78(32.2%) were diagnosed with somatic symptom disorder. The mean age of the diagnosed group was 53.53 years, while that of the non-diagnosed group was 59.15 years, indicating an older age in the non-diagnosed group. Compared to the non-diagnosed group, the diagnosed group was more likely to be unemployed and unmarried. The diagnosed group exhibited significantly higher scores on SSD-12, PHQ-9, GAD-7, VAS, and TAS, and significantly lower scores on DUFSS, EQ-5D-5L, and WHOQOL-BREF compared to the non-diagnosed group. The odds ratio (OR) for the current prevalence of somatic symptom disorder was 2.08 times higher in participants with moderate or higher GAD-7 scores and 1.83 times higher in those with TAS scores ≥52, indicating a potential for alexithymia or alexithymia. Higher VAS scores were associated with a 1.13-fold increase in the OR for somatic symptom disorder prevalence, while higher DUFSS scores were associated with a 0.97-fold decrease in the OR. Conclusion: SSD patients demonstrated distinct psychosocial characteristics with higher psychological burden and lower social support and quality of life. Anxiety, alexithymia, current pain, and reduced social support were significantly associated with SSD, underscoring the importance of psychosocial factors in early identification and intervention.

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