Assessment of patients by DSM-III-R and DSM-IV in a Japanese psychosomatic clinic

Mutsuhiro Nakao, Shinobu Nomura, Gaku Yamanaka, Hiroaki Kumano, Tomifusa Kuboki

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: The aim of this study was to investigate the clinical features of psychosomatic disorders in Japan. Methods: A total of 1432 outpatients (515 males and 917 females; 9-95 years of age, mean age 36) attending a psychosomatic clinic for the first time were assessed by the DSM-III-R or DSM-IV semistructured interview. Results: Major ICD-10 diagnoses found were eating disorder, other anxiety disorders, autonomic nervous dysfunction, somatoform disorders, and irritable bowel syndrome. The most frequent diagnosis on the DSM-III-R and DSM-IV axis I was 'somatoform disorders not otherwise specified', followed by bulimia nervosa, 'depressive disorder not otherwise specified', anorexia nervosa, conversion disorder, major depression or depressive disorder, 'panic disorder with agoraphobia', and 'psychological factors affecting physical or medical condition'. On axis II, 11-17% of the patients met the criteria for personality disorder. On axis IV, 78-80% had mild or moderate psychosocial stress; major psychosocial and environmental problems classified by the DSM-IV were the problems with primary supports and occupation. Conclusions: The results seem to reinforce the belief that the diagnoses on the DSM-III-R and DSM-IV axis I are inadequate for describing psychosomatic phenomena. A new diagnostic system in combination with the multidimensional assessments by the DSM-III-R and DSM-IV is needed to form the common guidelines of diagnoses and therapies in psychosomatic medicine.

Original languageEnglish
Pages (from-to)43-49
Number of pages7
JournalPsychotherapy and Psychosomatics
Volume67
Issue number1
DOIs
Publication statusPublished - 1998 Jan 1

Keywords

  • Anxiety
  • DSM-III-R
  • DSM-IV
  • Depression
  • Eating disorders
  • ICD-10
  • Japanese psychosomatic clinic
  • Psychosomatic disorder
  • Somatoform disorders

ASJC Scopus subject areas

  • Clinical Psychology
  • Applied Psychology
  • Psychiatry and Mental health

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