Heart Beat Perception in Patients with Depressive, Somatoform, and Personality Disorders

According to current concepts of functional psychosomatic disorders, disturbed interoceptive processes are considered relevant causal factors especially in relation to panic disorders and functional cardiac complaints. In our study, heart beat perception was assessed for subgroups of psychosomatic disorders and in comparison to healthy controls. A further issue was the distribution of performance scores across diagnostic subgroups. Special consideration was given to the question of panic patients forming two extreme groups with either better or worse perception than other patient groups. Additionally, a subsample of patients was tested twice in order to establish test-retest-reliability of heart beat perception. Within the whole group of 546 patients, marginally significant differences in heart beat perception scores in the Schandry Mental Tracking Task between subgroups became evident. The detection score of patients with personality disorders was lower compared to patients with functional disorders and healthy controls. Patients with functional heart disorder and panic patients did not have higher perception scores than controls. Effects of medication were taken into account. Only medicated panic patients showed better heart beat perception than unmedicated ones. The distribution of heart beat perception was similar in all groups studied, patients with panic disorders did not differ from the general picture. Time stability after a 4 week interval in 42 patients was sufficiently high to show trait characteristics reaching r = .58. In general, psychosomatic patients are characterized by a tendency towards lower perception scores compared to healthy subjects. Better than normal interoceptive functioning, in contrast to some literature reports, does not seem to play a decisive role in the establishment of functional psychosomatic disorders.