Three forms of somatization in primary care: prevalence, co-occurrence, and sociodemographic characteristics

Area of Science:

• Psychiatry
• General Practice
• Medical Sociology

Background:

• Somatization is a complex phenomenon with various presentations.
• Previous research has not fully differentiated the distinct forms of somatization.
• Understanding the prevalence and characteristics of somatization is important for primary care settings.

Purpose of the Study:

• To operationalize and assess the prevalence of three distinct definitions of somatization.
• To examine the sociodemographic and illness behavior characteristics associated with each somatization type.
• To explore potential distinct pathogenic processes underlying different somatization presentations.

Main Methods:

• Operationalized three definitions of somatization: functional somatic distress (Somatic Symptom Index), hypochondriasis (illness worry), and somatized presentations of depression/anxiety.
• Assessed 685 patients in two family medicine clinics.
• Utilized the Diagnostic Interview Schedule for the Somatic Symptom Index.

Main Results:

• 26.3% of patients met criteria for at least one form of somatization.
• Subsyndromal somatization disorder (SSI 4,6) affected 16.6% of patients, while DSM-III somatization disorder was 1%.
• Hypochondriacal worry and somatized depression/anxiety presentations each affected 7.7% and 8% of patients, respectively. The three forms were associated with different patient characteristics.

Conclusions:

• Somatization is common in primary care, with subsyndromal forms being more prevalent than formal DSM-III diagnosis.
• The distinct characteristics associated with each somatization type suggest different underlying causes.
• Further research into distinct pathogenic processes for each somatization type is warranted.