Three forms of somatization in primary care: prevalence, co-occurrence, and sociodemographic characteristics.
Three definitions of somatization were operationalized: (a) high levels of functional somatic distress, measured by the Somatic Symptom Index (SSI) of the Diagnostic Interview Schedule; (b) hypochondriasis measured by high scores on a measure of illness worry in the absence of evidence for serious illness; and (c) exclusively somatic clinical presentations among patients with current major depression or anxiety. Of 685 patients attending two family medicine clinics, 26.3% met criteria for one or more forms of somatization. While DSM-III somatization disorder had a prevalence of only 1% in this population, 16.6% of the patients met abridged criteria for subsyndromal somatization disorder (SSI 4,6). Hypochondriacal worry had a prevalence of 7.7% in the clinic sample. Somatized presentations of current major depression or anxiety disorder had a prevalence of 8%. The three forms of somatization were associated with different sociodemographic and illness behavior characteristics. A majority of patients met criteria for only one type of somatization, suggesting that distinct pathogenic processes may be involved in each of the three types.
Department of Psychiatry, McGill University, Montreal, Canada.
L J
LJ
Kirmayer
J M
JM
Robbins
D000328:Adult; D001008:Anxiety Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D006998:Hypochondriasis / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D013001:Somatoform Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D009626:Terminology as Topic