title: Descriptive Epidemiology of Somatising Tendency: Findings from the CUPID Study.
abstract: Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.
authors.affiliation: Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.|CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Vargas-Prada
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Coggon
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom.
authors.forename: Georgia
authors.initials: G
authors.lastname: Ntani
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom.
authors.forename: Karen
authors.initials: K
authors.lastname: Walker-Bone
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom.
authors.forename: Keith T
authors.initials: KT
authors.lastname: Palmer
authors.affiliation: School of Nursing, University of São Paulo, São Paulo, Brazil.
authors.forename: Vanda E
authors.initials: VE
authors.lastname: Felli
authors.affiliation: Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral-IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador.
authors.forename: Raul
authors.initials: R
authors.lastname: Harari
authors.affiliation: Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Lope H
authors.initials: LH
authors.lastname: Barrero
authors.affiliation: Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States of America.|Center for Disease Control and Prevention/National Institute for Occupational Safety and Health, Atlanta, Georgia, United States of America.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Felknor
authors.affiliation: Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States of America.
authors.forename: David
authors.initials: D
authors.lastname: Gimeno
authors.affiliation: North East London NHS Foundation Trust, Goodmayes Hospital, Ilford, United Kingdom.
authors.forename: Anna
authors.initials: A
authors.lastname: Cattrell
authors.affiliation: Epidemiology and Preventive Medicine Research Center, University of Insubria, Varese, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bonzini
authors.affiliation: Department of Social Medicine, Medical School, University of Crete, Heraklion, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Solidaki
authors.affiliation: Institute of Technology, Estonian University of Life Sciences, Tartu, Estonia.
authors.forename: Eda
authors.initials: E
authors.lastname: Merisalu
authors.affiliation: Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
authors.forename: Rima R
authors.initials: RR
authors.lastname: Habib
authors.affiliation: Department of Occupational Health, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Farideh
authors.initials: F
authors.lastname: Sadeghian
authors.affiliation: Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
authors.forename: M Masood
authors.initials: MM
authors.lastname: Kadir
authors.affiliation: Department of Medical Education and Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka.
authors.forename: Sudath S P
authors.initials: SS
authors.lastname: Warnakulasuriya
authors.affiliation: Department for Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Matsudaira
authors.affiliation: National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa.|Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
authors.forename: Busisiwe
authors.initials: B
authors.lastname: Nyantumbu
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Sim
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Helen
authors.initials: H
authors.lastname: Harcombe
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors.forename: Ken
authors.initials: K
authors.lastname: Cox
authors.affiliation: Federal University of Paraná, Curitiba-PR, Brazil.
authors.forename: Leila M M
authors.initials: LM
authors.lastname: Sarquis
authors.affiliation: School of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
authors.forename: Maria H
authors.initials: MH
authors.lastname: Marziale
authors.affiliation: Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral-IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador.
authors.forename: Florencia
authors.initials: F
authors.lastname: Harari
authors.affiliation: Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral-IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador.
authors.forename: Rocio
authors.initials: R
authors.lastname: Freire
authors.affiliation: Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral-IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador.
authors.forename: Natalia
authors.initials: N
authors.lastname: Harari
authors.affiliation: Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Magda V
authors.initials: MV
authors.lastname: Monroy
authors.affiliation: Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Leonardo A
authors.initials: LA
authors.lastname: Quintana
authors.affiliation: Program Health, Work and Environment in Central America, Institute for Studies on Toxic Substances (IRET), National University of Costa Rica, Heredia, Costa Rica.
authors.forename: Marianela
authors.initials: M
authors.lastname: Rojas
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom.
authors.forename: E Clare
authors.initials: EC
authors.lastname: Harris
authors.affiliation: Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.|CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.|Occupational Health Service, Parc de Salut MAR, Barcelona, Spain.
authors.forename: Consol
authors.initials: C
authors.lastname: Serra
authors.affiliation: Servicio de Investigación y Análisis IT/EP, Departamento de Investigación y Análisis de Prestaciones, MC Mutual, Barcelona, Spain.
authors.forename: J Miguel
authors.initials: JM
authors.lastname: Martinez
authors.affiliation: Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.|CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.|Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States of America.
authors.forename: George
authors.initials: G
authors.lastname: Delclos
authors.affiliation: Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.|CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Benavides
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Carugno
authors.affiliation: Epidemiology and Preventive Medicine Research Center, University of Insubria, Varese, Italy.
authors.forename: Marco M
authors.initials: MM
authors.lastname: Ferrario
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.|Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Angela C
authors.initials: AC
authors.lastname: Pesatori
authors.affiliation: Department of Social Medicine, Medical School, University of Crete, Heraklion, Greece.
authors.forename: Leda
authors.initials: L
authors.lastname: Chatzi
authors.affiliation: Department of Psychiatry, Medical School, University of Crete, Heraklion, Greece.
authors.forename: Panos
authors.initials: P
authors.lastname: Bitsios
authors.affiliation: CIBER of Epidemiology and Public Health, Barcelona, Spain.|IMIM (Hospital del Mar Research Institute), Barcelona, Spain.|Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.affiliation: North Estonia Medical Centre, Tallinn, Estonia.
authors.forename: Kristel
authors.initials: K
authors.lastname: Oha
authors.affiliation: Tartu University Hospital, Tartu, Estonia.
authors.forename: Tiina
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authors.affiliation: Klinikum Leverkusen, Leverkusen, Germany.
authors.forename: Ali
authors.initials: A
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authors.affiliation: Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka.|Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Roshini J
authors.initials: RJ
authors.lastname: Peiris-John
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors.forename: Nalini
authors.initials: N
authors.lastname: Sathiakumar
authors.affiliation: Faculty of Medicine, University of Kalaniya, Kelaniya, Sri Lanka.
authors.forename: A Rajitha
authors.initials: AR
authors.lastname: Wickremasinghe
authors.affiliation: Department of Joint Disease Research, 22nd Century Medical and Research Center, University of Tokyo, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Yoshimura
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Kelsall
authors.affiliation: Centre for Occupational and Environmental Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Victor C W
authors.initials: VC
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authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Urquhart
authors.affiliation: Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Sarah
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authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: McBride
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Herbison
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Andrew
authors.initials: A
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authors.affiliation: Health Safety and Environment Department, AkzoNobel, Houston, Texas, United States of America.
authors.forename: Eduardo J Salazar
authors.initials: EJ
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mesh_terms: D000328:Adult; D001294:Attitude to Health; D002489:Central America; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D000071896:Medically Unexplained Symptoms; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology; D009790:Occupations; D016017:Odds Ratio; D015995:Prevalence; D013001:Somatoform Disorders / Q000453:epidemiology*; D013020:South America; D011795:Surveys and Questionnaires; D055815:Young Adult