Executive Dysfunction Correlated With 2-Year Treatment Response in Patients With Late-Life Undifferentiated Somatoform Disorders

Psychosomatics. 2016 Jul-Aug;57(4):378-89. doi: 10.1016/j.psym.2016.02.006. Epub 2016 Feb 24.

Abstract

Background: Late-life somatoform disorders (SDs) are characterized by various aging-associated factors. Recently, cognitive decline, including executive dysfunction, has been reported as an etiological factor of late-life SDs. The response to treatment for late-life SDs varies from one patient to another. Treatment strategies for late-life SDs require these etiological factors to be considered. We hypothesized that the treatment response in patients with late-life SDs was associated with executive dysfunction.

Objective: The aim of the present study was to confirm the changes in disease severity over a 2-year follow-up period and to determine which etiological factors are related to the treatment response in patients with late-life SDs.

Methods: We examined 55 patients with late-life SDs who were treated with pharmacotherapy and supportive psychotherapy at baseline. The changes in the disease severity and cognitive profiles over a 2-year follow-up period were evaluated. Additionally, we investigated which etiological factors at baseline were related to treatment resistance.

Results: Of the 55 patients who were enrolled in the present study, 31 completed the 2-year follow-up period. Overall, the disease severity improved significantly in patients with late-life SDs. On the contrary, executive function decreased throughout the research period. Moreover, we found that executive dysfunction and the presence of hyperlipidemia at baseline were related to treatment resistance.

Conclusions: These results suggest that aging-associated etiological factors be considered for the treatment of late-life SDs.

Keywords: cognition; elderly; executive function; somatoform disorders; treatment.

MeSH terms

  • Aged
  • Antidepressive Agents / therapeutic use
  • Anxiety / psychology
  • Benzodiazepines / therapeutic use
  • Cognitive Dysfunction / psychology*
  • Executive Function*
  • Female
  • Follow-Up Studies
  • Humans
  • Late Onset Disorders
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Prognosis
  • Psychotherapy
  • Somatoform Disorders / psychology*
  • Somatoform Disorders / therapy

Substances

  • Antidepressive Agents
  • Benzodiazepines