MULTISYSTEM COMPLAINTS IN PATIENTS WITH THE IRRITABLE-BOWEL-SYNDROME AND FUNCTIONAL DYSPEPSIA

Somatoform disorder, a psychiatric disease manifest by abnormal concern with bodily functions and associated with multisystem complaints, can be confused with functional gastrointestinal disease. To determine whether patients with functional gastrointestinal disorders are simply a subset of patients with somatization, we evaluated how commonly multisystem complaints occurred in outpatients diagnosed as having functional gastrointestinal disease by using the previously validated psychosomatic symptom checklist. We also aimed to determine whether the checklist could discriminate somatoform disorder from various gastrointestinal diseases. We tested 115 patients with functional gastrointestinal disease (82 irritable bowel syndrome, 33 functional dyspepsia), 99 with organic gastrointestinal disease, 37 with an established diagnosis of somatoform disorder and 143 healthy subjects. All completed an independent diagnostic evaluation and a questionnaire which included the checklist. Scores for frequency and intensity of symptoms were similar in patients with functional and organic gastrointestinal diseases, but were increased compared with healthy controls. Patients with somatoform disorder had significantly higher scores than those with functional gastrointestinal disease. The psychosomatic symptom checklist discriminated somatoform disorder from functional gastrointestinal disease with a sensitivity of 63% and a specificity of 78%, and from organic disease with a sensitivity of 84% and specificity of 72%, respectively. We conclude that, while patients with functional gastrointestinal disease have an excessive tendency to complain of bodily sensations, this is similar to patients who have organic disease. This suggests that illness behavior may not be a characteristic feature of functional gastrointestinal disease.