Somatoform disorders: Comorbidity with other DSM-III-R psychiatric diagnoses in Greece

From a total sample of 1,448 psychiatric outpatients, 175 (12.1%) received a diagnosis of a somatoform disorder according to DSM-III-R criteria. One h undred twenty-two (70%) of these patients had another current axis I diagno sis, and this rate increased to 79% (139 of 175) when lifetime psychiatric diagnoses were recorded. The most frequent comorbid diagnoses were depressi ve disorders, i.e., dysthymia and major depression, and then anxiety disord ers, mainly panic disorder. One hundred ten (63%) of the somatoform patient s met the criteria for a personality disorder, significantly higher than th e rate (52%) for the rest of the total sample (n = 1,273), who were used as a control group. The most frequent comorbid personality disorders were his trionic, dependent, and personalities of cluster B in general. Hypochondria sis was the only somatoform disorder that was additionally significantly re lated to obsessive-compulsive personality disorder. Somatoform patients wit h a concomitant personality disorder manifested more severe overall psychop athology as measured by the Minnesota Multiphasic Personality Inventory (MM PI) and a worse level of functioning than those without. The results of the present study show that (1) patients with somatoform disorders have a high rate of comorbidity with other clinical syndromes and personality disorder s, and (2) the presence of a personality disorder is related to more severe overall psychopathology and a worse level of functioning. All of the above indicate that special attention must be paid to the interaction between so matoform disorders, other clinical syndromes, and personality structure at the level of both clinical and research practice. Copyright (C) 1999 by W.B . Saunders Company.