LOIN PAIN AND HEMATURIA SYNDROME - A SOMATOFORM DISORDER

Fifteen patients with the loin pain and haematuria syndrome (LPH) were compared with 10 patients with complicated renal stone disease referr ed to the same tertiary centre and matched for age, sex and duration o f illness. LPH patients had a history of three times more medically un explained somatic symptoms other than loin pain (p<0.01) and a higher proportion took analgesics regularly (p<0.01). The onset of pain was a ssociated with an adverse psychologically important life-event in eigh t of the LPH patients but in none of the controls (p<0.02). LPH patien ts more frequently recalled serious parental illness and disability in childhood (p<0.001) than controls, and a higher proportion felt respo nsible for causing or alleviating parental illness or distress (p<0.05 ). LPH subjects scored higher in the 'paternal care' dimension of the Parental Bonding Instrument (p<0.05). No difference was found between EPH patients and controls in terms of current depression and anxiety b ut both groups exhibited high rates of lifetime depression. LPH patien ts expressed lower levels of anger and hostility (p< 0.002) than did c ontrols. Our observations suggest that psychological factors are of ma jor importance in the aetiology of LPH, which may represent a type of somatoform pain disorder.