Body image and self-esteem in somatizing patients.

AIM: The aim of the present study was to determine dissatisfaction with body appearance and bodily functions and to assess self-esteem in somatizing patients. METHODS: Body image and self-esteem were investigated in 128 women; 34 of those had diagnosed somatoform disorders, 50 were breast cancer patients with total mastectomy surgery alone, and 44 were healthy subjects. Body image and self-esteem were assessed using the Body Cathexis Scale and Rosenberg Self-Esteem Scale. RESULTS: The two clinical groups did not differ from one another (z = -1.832, P = 0.067), but differed from healthy controls in terms of body image (somatizing patients vs healthy controls, z = -3.628, P < 0.001; total mastectomy patients vs healthy controls, z = -3.172, P = 0.002). They also did not differ significantly in terms of self-esteem (z = -0.936, P = 0.349) when depressive symptoms were controlled. No statistically significant difference was observed between total mastectomy patients and healthy controls in terms of self-esteem (z = -1.727, P = 0.084). The lower levels of self-esteem in somatizing patients were largely mediated by depressive symptoms. Depressed and non-depressed somatizing patients differed significantly from healthy controls with respect to their self-esteem and body image. CONCLUSIONS: Somatizing patients who were dissatisfied with their bodily functions and appearance had lower levels of self-esteem and high comorbidity of depression. In clinical practice it is suggested that clinicians should take into account psychiatric comorbidity, self-esteem, and body image in somatizing patients when planning treatment approaches.

[Domestic violence and female patients]. / Aile Içi Fiziksel Siddet ve Kadin Hastalarimiz.

OBJECTIVES: 1. To investigate the life-time prevalence of spousal physical abuse, history of childhood physical abuse, and child physical abuse among female outpatients and the relationship between the three; 2. To investigate the characteristics of physical abuse; 3. To investigate the socio-demographic and cultural features of physical abuse. METHOD: Domestic violence and its features were investigated for 3 generations in 100 female psychiatric outpatients using standard semi-structured interviews. SCID-I was used for psychiatric diagnoses. Clinical, socio-demographic, and family structure features were compared in abused and non-abused groups. FINDINGS: Lifetime prevalence of spousal physical abuse was 62%, 63% of the patients were physically abused in their homes during childhood, and 51% reported that they physically abused their children. The spouse-abused and non-abused groups did not differ in education level, occupation, family income, age at marriage, form of marriage, and history of childhood domestic violence. Age, extended family, and an alcohol-consuming husband were significantly correlated with spousal physical abuse. Perpetrating child abuse was significantly correlated with history of childhood physical abuse and spousal physical abuse. CONCLUSIONS: Domestic violence is a common problem among female psychiatric patients. Child abuse, spousal abuse, and history of childhood abuse are correlated.