SAN FRANCISCO — In somatic symptom disorder, patients develop too much focus on physical symptoms, such as pain, weakness or shortness of breath, which causes them significant distress and often creates problems for normal function, according to the American Psychiatric Association.
Those excessive thoughts, feelings and behaviors relating to the physical symptoms are believed to be associated with post-traumatic stress disorder or major depressive disorder in injured military servicemembers. Research regarding the association between clinician-determined injury severity and PTSD or MDD has not been definitive, however.
That’s why a San Francisco VA Healthcare System-led study sought to investigate whether somatic symptoms or injury severity better predict the development of probable PTSD or MDD in wounded servicemembers medically evacuated from combat areas.
For the report in the Journal of Traumatic Stress, researchers gathered data, including wounded servicemembers’ demographic characteristics, clinician-determined injury severity (i.e., Injury Severity Score [ISS] and Abbreviated Injury Scale [AIS] values), and self-report assessments of PTSD (PTSD Checklist-Civilian Version), MDD (Patient Health Questionnaire [PHQ]-9), and somatic symptoms (PHQ-15).1
The study noted that 2,217 of the servicemembers completed at least one self-assessment between 2003 and 2014, with 425 having completed assessments at each assessment period (AP), conducted 1-75 (AP1), 76-165 (AP2), and 166-255 (AP3) days post-injury.
Results indicated that, between AP1 and AP3, the rates of probable PTSD and MDD increased from 3.0% to 11.7% and from 2.8% to 9.2%, respectively.
“Somatic symptom severity at AP1 predicted probable PTSD and MDD at all three APs, odds ratios (ORs) = 3.5-11.5; however, ISS values did not predict probable PTSD or MDD at any AP, ORs = 0.6-0.9,” the authors wrote. “This suggests that the initial severity of self-reported somatic symptoms rather than clinician-determined injury severity predicts the development of probable PTSD and MDD in wounded SMs.”
- Soumoff AA, Clark NG, Spinks EA, Kemezis PA, Raiciulescu S, Driscoll MY, Kim SY, Benedek DM, Choi KH. Somatic Symptom Severity, Not Injury Severity, Predicts Probable Posttraumatic Stress Disorder and Major Depressive Disorder in Wounded Service Members. J Trauma Stress. 2021 Aug 9. doi: 10.1002/jts.22722. Epub ahead of print. PMID: 34374129.
