Comparative analysis of emotional factors in patients with somatic symptom disorder and panic disorder 2025 Yoon et al

Abstract

Objective
This study investigated the emotional symptom profiles and treatment responses in patients exhibiting overlapping physical symptoms to compare differences between Somatic Symptom Disorder (SSD) and Panic Disorder (PD).

Methods
Pharmacotherapy outcomes were analysed in 208 outpatients with SSD (n = 94) and PD (n = 114). Stepwise multivariable logistic regression identified predictors of treatment response, considering variables such as the Clinical Global Impression-Severity (CGI-S), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory, and State-Trait Anger Expression Inventory. Network analysis explored emotional patterns by estimating network structures for each group.

Results
The overall response rate to pharmacotherapy was 23.6% (49/208), with no significant difference between groups. Baseline CGI-S and BDI-II scores were significant predictors of treatment response in both groups, while social phobia score was a significant predictor in PD. Depression and anxiety were related to physical symptoms in both groups, but anger was significantly associated only in SSD. Network analysis revealed that depression was central to other symptoms in SSD, while anxiety was the core symptom in PD, indicating different emotional drivers between the disorders.

Conclusions
This study suggests the differences in emotional symptom profiles between SSD and PD. Findings suggest different mechanisms, considering the role of anger in SSD, highlighting the need for more personalised treatments for each disorder.

KEY POINTS

• Emotional symptom profiles differ between Somatic Symptom Disorder (SSD) and Panic Disorder (PD).
  
  
• Depression is central in SSD, while anxiety is the core symptom in PD, with anger specifically associated with SSD.
  
  
• Personalised treatments are needed due to the distinct emotional mechanisms driving each disorder.
  

Open access

 

Showing an association between certain emotional states and these disorders and treatment responses does not mean the emotional state is driving the disorder. It could just as well be the other way around, that the disorder is causing the emotional state.

 

Or/and how they are being treated/not treated as part of that

I’m sure ethics wouldn’t allow it (which says it all) but there’s some 60s style experiment missing where any HCPs with a health condition (obviously using some blinded randomisation) walking into x clinic/dept get met with a physician who is only ever going to tell them it’s somatic then write some narrative in their notes. And leaves them panicking for enough time that they think this is their new destiny before they then fill in an anxiety survey.

although maybe they would be in the loop enough to know not to say they are anxious and assume they can find a second opinion etc and it needs to be a different cross-matched cohort - but at least they’d probably have an inkling of the implications that would be waiting for them from such a label