Which symptoms are the psychopathological core affecting the manifestation of pseudo-cardiac symptoms and poor sleep quality in young adults? Symptoms of personality disorders versus clinical disorders

BACKGROUND: Diagnosing and identifying the psychological origin of pseudo-cardiac symptoms and comorbid conditions such as poor sleep quality is very difficult due to its extensive and complex nature. The present study was conducted to determine the contribution of symptoms of personality disorders (PDs) and clinical disorders (CDs; i.e., psychological symptoms measured using the Symptom Checklist-90) to the manifestation of pseudo-cardiac symptoms and poor sleep quality. METHODS: Subjects in this cross-sectional study were 953 (64.3% female; 28.8 ± 6.2 years) community samples in the west of Iran who were selected by convenience sampling. After applying the inclusion criteria, data were collected using the Symptom Checklist-90 (SCL-90-R), the Personality Diagnostic Questionnaire (PDQ-4), and the Scale for Pseudo-Cardiac Symptoms and Poor Sleep Quality (SPSQ). Pearson correlations, factor analytical techniques, and hierarchical regression models were used to examine associations between symptoms of PDs/CDs and outcome factors. RESULTS: Factor analytical techniques confirmed both the integrated structure of symptoms of PDs and CDs. Both pseudo-cardiac symptoms and poor sleep quality were more strongly associated with symptoms of CDs than PDs. The results of the hierarchical analysis show that the CDs factor alone could explain the total variance of both pseudo-cardiac symptoms (change in R(2) = 0.215 vs. 0.009; p < 0.001) and poor sleep quality (change in R(2) = 0.221 vs. 0.001; p < 0.001). CONCLUSION: The different capabilities of two unique factors for the symptoms of PDs and CDs were confirmed by factor analytical methods and regression analysis techniques. Although each of the symptoms of PDs and CDs independently contributes to the manifestation of pseudo-cardiac symptoms and poor sleep quality, the CDs factor is the psychopathological core.