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Somatoform pain disorder in the general population
Hans Joergen Grabe1, Christian Meyer, Ulfert Hapke
1Department of Psychiatry, Ernst-Moritz-Arndt-University of Greifswald, Stralsund, Germany. grabeh@uni-greifswald.de
Psychotherapy and Psychosomatics
|February 26, 2003
Summary
Chronic pain disorder is a common condition, affecting over 33% of people lifetime. However, only a third experience significant distress, highlighting diagnostic challenges for somatoform pain disorder.
Area of Science:
- Psychiatry
- Epidemiology
- Pain Medicine
Background:
- Chronic pain disorder is a prevalent and disabling condition.
- Limited data exists on the community prevalence of somatoform pain symptoms and disorder.
Purpose of the Study:
- To determine the prevalence of somatoform pain disorder in the general population.
- To assess the impact of diagnostic criteria (DSM-III-R vs. DSM-IV) on prevalence rates.
Main Methods:
- Administered German versions of the Composite International Diagnostic Interview to 4,075 individuals.
- Diagnosed somatoform pain disorder using DSM-III-R criteria, with a subgroup assessed for DSM-IV criterion B (significant distress/impairment).
Main Results:
- Lifetime prevalence of somatoform pain disorder (DSM-III-R) was 33.7%; 6-month prevalence was 17.3%.
- Applying DSM-IV criterion B reduced prevalence to 12.3% (lifetime) and 5.4% (6-month).
- Over 95% sought medical care for pain; 25% linked pain to psychological factors; female:male ratio was 2:1.
Conclusions:
- Somatoform pain disorder (DSM-III-R) is frequent, but severe distress/impairment affects only about one-third.
- Further refinement of DSM-IV criterion C is needed for population surveys.
- Operationalizing psychological factors is crucial for accurate diagnosis in general populations.