Network analysis of body-related complaints in patients with neurotic or personality disorders referred to psychotherapy

Background: Psychopathology theory and clinical practice require the most complex knowledge about patients' complaints. In patients seeking for psychotherapy, body-related symptoms often complicate treatment. Aim: This study aimed at examining connections between body-related symptoms, and identification of symptoms which may be responsible for emergency and sustaining of anxiety, somatoform and personality disorders with the use of network analysis. Methods: In our retrospective research we used data from a sample of 4616 patients of the Department of Psychotherapy, University Hospital in Cracow, diagnosed with anxiety, somatoform or personality disorders. We constructed the Triangulated Maximally Filtered Graph (TMFG) networks of 44 somatoform symptoms endorsed in the symptom checklist "O" (SCL-O) and identified the most central symptoms within the network for all patients and in subgroups of women vs. men, older vs. younger, and diagnosed in 1980-2000 vs. 2000-2015. We used bootstrap to determine the accuracy and stability of five networks' parameters: strength, expected influence, eigenvector, bridge strength and hybrid centrality. Results: The most central symptoms within the overall network, and in six subnetworks were dyspnea and migratory pains. We identified some gender-related differences, but no differences were observed for the age and time of diagnosis. Conclusions: Self-reported dyspnea and migratory pains are potential important targets for treatment procedures.