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Somatoform and Substance Use Disorders

From the New York State Psychiatric Institute (D.H., H.K.), New York, New York; Department of Epidemiology (D.H.), Mailman School of Public Health, Columbia University, New York, New York; and the Department of Psychiatry (D.H.), College of Physicians and Surgeons, Columbia University, New York, New York.

Address correspondence and reprint requests to Deborah Hasin, Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive, Box 123, New York, NY 10032. E-mail: dsh2{at}columbia.edu

ABSTRACT

Objective: To review the potential for diagnostic difficulties and overlap in a number of symptoms of somatoform disorders and symptoms of withdrawal from alcohol and drugs, and to review epidemiologic, family, and clinical studies addressing comorbidity between somatoform and substance use disorders. The comorbidity between somatoform disorders and substance use disorders has rarely been studied.

Methods: Symptoms of somatoform disorders and substance withdrawal were compared. A PubMed-based literature review was conducted.

Results: Somatoform and withdrawal symptoms overlap considerably. Few studies, however, have addressed comorbidity between somatoform and substance use disorders. Although results are inconsistent, a number of studies suggest that an association exists.

Conclusion: More research on this type of comorbidity is warranted because the associations may be stronger than generally assumed. Such research should address methodological problems to produce studies with clearer findings.

Key Words: somatoform • substance • abuse • dependence • somatization

Abbreviations: ECA = Epidemiologic Catchment Area; USD = undifferentiated somatoform disorder; SSI = Somatic Symptom Index; SSI4,6 = Somatic Symptom Index, 4 symptoms (men) and 6 symptoms (women).

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