Somatic obsession

Hopkins Symptom Checklist. The Hopkins Symptom Checklist (HSCL) is a scale that has been used to measure the presence and intensity of various symptoms in outpatient neurotic patients. It is a 58-item self-rating scale and has generally been replaced by the Self-Report Symptom Inventory (SCL-90). It measures the symptoms during the past week and requires approximately 20 minutes to complete. There are five subtests somatization, obsessive-compulsive, interpersonal sensitivity, depression, and anxiety. 

Self-Report Symptom Inventory. Each of the 90 items in the SCL-90 uses a five-point scale of distress. It was designed as a general measure of symptomatology for use by adult psychiatric outpatients in either a research or clinical setting. It rates either the present or previous week. It requires about 15 minutes for the patient to complete this form and about 5 minutes for a technician to verify identifying information. This test is sensitive to drug effects and may be used with inpatients. Nine subscales are measured somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, anger-hostility, phobic anxiety, paranoid ideation, and psychoticism. 

Somatoform Disorders. Similarities also exist between OCD and certain somatoform disorders. For example, somatic obsessions occurring in OCD resemble hypochondriasis. These can usually be distinguished in that those with OCD have typically experienced other nonsomatic obsessions during the course of their illness and typically engage in classic compulsive behaviors to alleviate, albeit temporarily, their somatic concerns. 

Symptom Checklist-90-Revised (SCL-90-R). The SCU-90-R is a 90-item, self-administered, inventory developed by Derogatis in 1977 and is derived from the Hopkins Symptom Checklist (17). The inventory was developed to screen for psychopathology and assesses symptomatic distress in nine primary dimensions and three global indices of distress. The dimensions include somatization, obsessive-compulsive features, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoti-cism. The measure takes 15 to 20 minutes to complete. It has been used widely with community adolescents and adults, inpatients, and outpatients. It has been shown to have good reliability and validity (18). 

The most common obsessions faced by patients with OCD involve fears of contamination. This fear may focus on germs and infectious diseases, household chemicals, environmental pollutants, or bodily wastes. These contamination obsessions most often result in washing compulsions but may also produce compulsive visits to health care providers. Obsessional doubts (e.g., Did I remember to. .. ) are typically associated with checking compulsions. Another common obsession, need for symmetry and exacmess, leads to compulsive arranging, ordering, or counting. Obsessions may also be aggressive, somatic, or sexual in content. 

In a double-blind study nine patients with obsessive-compulsive disorder were given four single-doses of psilocybin 25-300 micrograms/kg (9). One had transient hypertension unrelated to anxiety or somatic symptoms, but there were no other significant adverse effects. 

In 800 Yemeni adults (aged 15-76 years) sjmptoms that might have been caused by the use of khat were elicited by face-to-face interviews 90 items covered nine scales of the following domains somatization, depression, anxiety, phobia, hostility, interpersonal sensitivity, obsessive-compulsive, hostility, interpersonal sensitivity, paranoia, and psychoticism (17). At least one life-time episode of khat use was reported in 82% of men and 43% of women. The incidence of adverse psychological symptoms was not greater in khat users, and there was a negative association between the use of khat and the incidence of phobic symptoms. 

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