Diagnostic comparison between psychosomatic and neurotic patients using the diagnostic and statistical manual of mental disorders third edition- revised

To distinguish the clinical features between psychosomatic illness and neurotic illness, 191 psychosomatic patients (male 39%) and 164 neurotic patients (male 43%) aged 25 to 65 years were diagnosed by the semi-structured interview using the Diagnostic and Statistical Manual of Mental Disorders third edition-revised (DSM-III-R) and these results were recorded in the database. The major diagnoses in the psychosomatic group were somatoform disorder not otherwise specified, bulimia nervosa, and psychological factors affecting physical condition. Similarly, those in the neurotic group were panic disorder with agoraphobia, hypochondriasis, and conversion. The numbers of patients with personality disorders were 33 (17%) in psychosomatic group and 34 (21%) in neurotic group, and the prevalence rates of personality disorder did not differ significantly between the two groups. The psychosocial stress score was lower in the psychosomatic group (none: 19%, mild: 61%, moderate: 17%, and severe-: 3%), compared with the neurotic group (none: 7%, mild: 65%, moderate: 23%, severe-: 5%). The psychosocial and occupational functioning score was higher in the psychosomatic group (70.2 ± 11.1), compared with the neurotic group (67.8±10.1) (Mean±S.D.). Although the differences between psychosomatic illness and neurotic illness were clarified by the DSM-III-R, limitations on the DSM-III-R assessments such as weak correspondence between psychosomatic illness and 'psychological factors affecting physical condition' were also found in the present study.