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Somatic symptom severity and psychological distress among immigrants: findings from a population-based study
Eva M Klein1, Johannes Kruse2, Bernd Löwe3
1Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
Background:
Somatic symptoms are frequently reported among immigrants, yet their occurrence and association with psychological distress remain understudied in population-based research using validated and measurement-invariant instruments. This study assessed the measurement invariance of the Somatic Symptom Scale-8 (SSS-8) and compared somatic symptom severity (SSS) between first- and second-generation immigrants and non-immigrants in a German population sample.
Materials And Methods:
Somatic symptom severity and psychological distress were assessed using the SSS-8 and PHQ-4, respectively. Multi-group confirmatory factor analysis was conducted to test the measurement invariance of the SSS-8. Group differences were examined with ANOVA, and hierarchical regression analyses were performed to explore associations between immigration status and SSS, adjusting for distress and sociodemographic variables.
Results:
The sample included N = 6860 participants (46.8% women; M = 49.4 years, SD = 18.1), comprising n = 504 first-generation immigrants and n = 472 second-generation immigrants. The SSS-8 demonstrated measurement invariance across groups. Pain was the most frequently reported symptom. High or very high SSS was reported by 9.9% of first-generation immigrants, 12.7% of second-generation immigrants, and 7.5% of non-immigrants. In hierarchical regression models, second-generation immigrant status (ß = .15; 95% CI, 0.08-0.22; p < .001) was associated with greater SSS alongside higher age, female gender, lower income, and distress.
Conclusions:
In this study, the SSS-8 demonstrated measurement invariance across immigrant and non-immigrant populations, supporting its applicability for research in diverse sociocultural contexts. The findings suggest a higher vulnerability to SSS and distress among second-generation immigrants, emphasizing the need for targeted screening to improve early identification and healthcare access. However, clinical studies are needed to replicate these findings.
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