Somatoform pain disorder in the general population.
BACKGROUND
Chronic pain disorder is assumed to represent a frequent and disabling condition. However, data on the prevalence of somatoform pain symptoms and somatoform pain disorder in the community are limited to date.


METHODS
German versions of the Composite International Diagnostic Interview were administered to a representative national sample of 4,075 people. Somatoform pain disorder was diagnosed by standardized diagnostic algorithm based on the DSM-III-R criteria (absence of adequate physical findings). One subgroup was identified as also meeting the DSM-IV criterion B for 'significant distress or psychosocial impairment due to the somatoform pain'.


RESULTS
A lifetime prevalence rate of somatoform pain disorder according to DSM-III-R of 33.7% and a 6-month rate of 17.3% was found. When applying the DSM-IV B criterion, the prevalence rate dropped to 12.3 and 5.4%, respectively. In both groups more than 95% of the probands had contacted their doctor because of the pain. In 25% of the probands the pain was positively assigned to psychological factors. A female:male ratio of 2:1 was found.


CONCLUSIONS
Somatoform pain disorder (DSM-III-R) is a frequent condition. However, only about one third of these subjects is severely distressed or impaired by the pain. A clear operationalized concept of the DSM-IV criterion C 'psychological factors are judged to have an important role in the onset, severity, exacerbation or maintenance of the pain' should be provided in the further development of the diagnosis 'pain disorder' in order to make this diagnosis suitable for general population surveys.
Grabe
Hans Joergen
HJ
Department of Psychiatry, Ernst-Moritz-Arndt-University of Greifswald, Stralsund, Germany. grabeh@uni-greifswald.de
Meyer
Christian
C
Hapke
Ulfert
U
Rumpf
Hans-Juergen
HJ
Freyberger
Harald Juergen
HJ
Dilling
Horst
H
John
Ulrich
U
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000465:Algorithms; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology*