title: Prevalence of somatic indicators of distress in diabetes patients: comparison to psychiatric patients and community nonpatients.
abstract: OBJECTIVE
  Because psychiatric screening methods are usually developed using psychiatric samples but not medical samples, they often include distress indicators that overlap with medical illness. This potentially inflates psychopathology estimates for medically ill patient groups. The objective of this study was to determine whether somatic distress indicator base rates are elevated in diabetes patients.
  
  
  METHODS
  The occurrence of Symptom Checklist 90-R (SLC-90-R) somatic symptoms was studied in fifty-six diabetes mellitus patients (27 insulin dependent, 29 non-insulin dependent) with non-elevated SLC-90-R profiles, as compared to both community nonpatient and psychiatric patient norms.
  
  
  RESULTS
  Of the fifteen SCL-90-R items rated by endocrinologists as most likely to be diabetes-related, nine were endorsed more frequently by diabetes patients than by nonpatients: faintness/dizziness (endorsed by 36% of diabetics), reduced libido (endorsed by 41%), anenergia (68%), memory problems (66%), trembling (18%), numbness (55%), weakness (39%), overeating (59%), and somatic concerns (41%). Anergia and faintness/dizziness were endorsed more frequently by psychiatric patients than diabetes patients, whereas numbness was endorsed more often by diabetes patients.
  
  
  CONCLUSIONS
  Conservatism is warranted when applying these somatic indicators of distress to diabetes patients. Further studies are needed to determine whether such illness overlap biases case classification.
authors.affiliation: Department of Psychiatry, University of Chicago, IL 60637-1470, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Aikens
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D008875:Middle Aged; D010555:Personality Inventory; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology*