Identifying somatization disorder in a population-based health examination survey: psychosocial burden and gender differences.
Despite its enormous medical burden, little is known about the epidemiology of somatization in the community. The present study screened a representative population-based survey of 7,466 subjects in the age range of 25 to 69 years for the occurrence of somatization. A total of 137 (1.84%) individuals experienced six or more symptoms from at least two different body sites without an identifiable organic cause. These patients exhibited a lower quality of life (P < or = 0.0001) and suffered from higher levels of emotional stress (P < or = 0.0001) than their counterparts in the healthy subsample (n=906). Somatization was not associated with a medical diagnosis, but disability days, the use of medical services, and the level of medication was higher in the somatization disorder group (P < or = 0.004). The somatization risk was only 1.6-fold higher for women in comparison to men but escalated for women rapidly to an approximately 4-fold risk when being female was combined with low social class and high emotional distress. Against expectation, the somatization risk for men also mounted 3-fold under the identical risk constellation.
Ladwig
K H
KH
Institut und Poliklinik für Psychosomatische Medizin, Med Psychologie und Psychotherapie des Klinikums Rechts der Isar der Technischen Universität München, Germany. ladwig@gsf.de
Marten-Mittag
B
B
Erazo
N
N
Gündel
H
H
D000328:Adult; D000368:Aged; D017281:Cost of Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010808:Physical Examination; D011159:Population Surveillance; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires