THE RELATIONSHIP BETWEEN COMPLEX POST-TRAUMATIC STRESS DISORDER AND SOMATIC SYMPTOMS BASED ON PHQ-15 AND ITQ DATA

Aim. To determine the nature of the relationship between complex post-traumatic stress disorder (CPTSD) and the severity of somatic symptoms in an outpatient sample, and to assess the contribution of individual CPTSD symptom clusters to the level of somatization and quality of life.Materials and methods. A cross-sectional questionnaire-based study of 200 outpatients of a psychiatric service was conducted (aged 18 to 58 years; 75.5% women). The International Trauma Questionnaire (ITQ) was used to diagnose PTSD and CPTSD according to ICD-11 criteria, the Patient Health Questionnaire (PHQ-15) was used to assess somatization, and the Chaban Quality of Life Scale (CQLS) was used to assess subjective quality of life. Non-parametric statistical methods (Mann-Whitney and Kruskal-Wallis tests, Spearman's rank correlation), the Fisher-Freeman-Halton exact test, and multiple linear regression were applied; the significance level was set at 0.05.Results. CPTSD criteria were met by 55 individuals (27.5%), PTSD criteria by 23 (11.5%), and the remaining 122 formed the no-diagnosis group. The level of somatization was significantly higher in the CPTSD group than in the remainder of the sample (15.49 versus 10.61 points; p < 0.001; effect size r = 0.51). A severe level of somatization was found in 58.2% of individuals with CPTSD, compared with 17.4% of those with PTSD and 21.3% of those without a diagnosis. Significant positive correlations were found between PHQ-15 and ITQ scores (rs = 0.38-0.43; p < 0.001). According to the regression analysis, CPTSD was an independent predictor of somatization (β = 4.29; p < 0.001), whereas isolated PTSD had no significant effect (p = 0.609). Quality of life was lowest in the CPTSD group and was more strongly associated with the disturbances in self-organization (DSO) cluster (rs = -0.53) than with PTSD symptoms (rs = -0.32).Conclusions. Complex PTSD, unlike isolated PTSD, is associated with substantially higher levels of somatization and lower quality of life. The disturbances in self-organization cluster plays a leading role in this relationship, justifying targeted screening for somatic symptoms in patients with complex psychological trauma.