Somatization in a primary care service for immigrants

Area of Science:

• Medical Sociology
• Cross-cultural Psychology
• Primary Care Research

Background:

• Somatization, the expression of psychological distress through physical symptoms, is a significant concern in primary care settings.
• Immigrant populations often face unique stressors that can influence their health-seeking behaviors and symptom presentation.
• Understanding variations in somatization across different immigrant groups is crucial for culturally sensitive healthcare delivery.

Purpose of the Study:

• To investigate the prevalence and patterns of somatization among a large cohort of immigrants accessing primary care.
• To compare somatization rates across major immigrant groups (Europeans, Asians, South Americans, Africans) and specific national subgroups.
• To identify risk factors and protective factors associated with somatization in diverse immigrant populations.

Main Methods:

• A cross-sectional study involving 3051 immigrants during their first primary care visit.
• Utilized the 21-item Bradford Somatic Inventory (BSI-21) to assess somatization, with a threshold of 14 or higher indicating somatization.
• Employed multiple logistic regression analysis, adjusting for covariates, to determine the relative risk of somatization among different groups.

Main Results:

• Overall, 25.6% of the immigrant sample were identified as somatizers.
• South Americans exhibited the highest prevalence of somatization (30.1%).
• After statistical adjustment, Asians and Europeans had a significantly lower risk of somatization compared to South Americans. Peruvians (32.9%) and certain African subgroups showed higher rates, while specific Asian subgroups (e.g., Filipino, Sri Lankan) and Eastern European migrants showed lower rates compared to Peruvians.

Conclusions:

• Somatization is a common way for socially disadvantaged immigrants to express distress within primary care settings, affecting approximately one-fourth of the studied population.
• Significant variations in somatization likelihood exist across different immigrant groups, with South Americans and some African subgroups showing higher prevalence.
• Targeted interventions and culturally adapted approaches are needed to address the diverse expressions of distress among immigrant patients.