The role of loss in treatment outcomes of persistent somatization.

The present study examines the effect of loss on treatment outcome in 92 persistently somatizing patients treated in an inpatient program. Patients were divided into one of three groups depending on the form of loss they experienced: early loss (loss of a parent before the age of 17, N = 25); recent loss (bereavement within the last 2 years, N = 21); or no loss (N = 46). The results indicate that patients experiencing an early loss had the poorest treatment outcome. The early loss group was characterized by poorer social adjustment prior to entry into the program compared with the recent loss group and a greater incidence of dependent personality disorder. The recent loss group showed the best outcome following treatment. The results support the concept that persistent somatization may arise from many precipitating factors. Assessing loss experiences in the patient may be an important factor in developing appropriate treatment strategies.