Total somatic symptom score as a predictor of health outcome in somatic symptom disorders.
BACKGROUND
The diagnosis of somatisation disorder in DSM-IV was based on 'medically unexplained' symptoms, which is unsatisfactory.


OBJECTIVE
To determine the value of a total somatic symptom score as a predictor of health status and healthcare use after adjustment for anxiety, depression and general medical illness.


METHODS
Data from nine population-based studies (total n = 28 377) were analysed.


RESULTS
In all cross-sectional analyses total somatic symptom score was associated with health status and healthcare use after adjustment for confounders. In two prospective studies total somatic symptom score predicted subsequent health status. This association appeared stronger than that for medically unexplained symptoms.


CONCLUSIONS
Total somatic symptom score provides a predictor of health status and healthcare use over and above the effects of anxiety, depression and general medical illnesses.
Barbara Tomenson, MSc, Biostatistics Unit, Institute of Population Health, University of Manchester, UK; Cecilia Essau, PhD, Department of Psychology, Whitelands College, University of Roehampton, London, UK; Frank Jacobi, PhD, Technische Universität Dresden, Germany; Karl Heinz Ladwig, PhD, Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany; Kari Ann Leiknes, MD, PhD, Norwegian Knowledge Centre for the Health Services, Oslo, Norway; Roselind Lieb, PhD, Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Switzerland; Gunther Meinlschmidt, PhD, Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Switzerland, and Research Department of Psychobiology, Psychosomatics and Psychotherapy, Clinic of Psychosomatic Medicine and Psychotherapy, LWL University Hospital & Faculty of Medicine, Ruhr University Bochum, Germany; John McBeth, PhD, Arthritis Research UK Primary Care Centre, Keele University, UK; Judith Rosmalen, PhD, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands; Winfried Rief, PhD, Department of Clinical Psychology, University of Marburg, Germany; Athula Sumathipala, MD, PhD, King's College London, UK; Francis Creed, FMedSci, Institute of Brain, Behaviour and Mental Health, University of Manchester, UK.
Barbara
B
Tomenson
Cecilia
C
Essau
Frank
F
Jacobi
Karl Heinz
KH
Ladwig
Kari Ann
KA
Leiknes
Roselind
R
Lieb
Gunther
G
Meinlschmidt
John
J
McBeth
Judith
J
Rosmalen
Winfried
W
Rief
Athula
A
Sumathipala
Francis
F
Creed
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012720:Severity of Illness Index; D017678:Sex Distribution; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D055815:Young Adult