A scoping review of somatization: characteristics and implications among health profession students

Somatization has gained recognition for its potential impact on medical students' quality of life and career longevity, who function in a high-stress environment and frequently have poor mental health, but somatization is much less researched among other health profession students who strive to excel in the same environments. Both mental and physical health issues predict leaving a career in healthcare. The aims of this scoping review were to describe and characterize somatic symptoms related to mental health in medical, dental, veterinary, nursing, and physical therapy students; define the outcome measures of somatization which were used; and document the existing evidence for interventions to prevent or treat somatization in these populations.

Developed in alignment with PRISMA-ScR guidelines, a comprehensive search was performed with 17 databases, bibliographic searching, and hand- searching, with eligible primary studies having medical, dental, veterinary, nursing, or physical therapy students, at least one measure of somatization or a statistical analysis of separate mental and physical health measures, written in or translated into English. Data charting was performed by a trained researcher and two authors reviewed each article.

Seventy-three articles met inclusion criteria, inclusive of 51 medical, 14 nursing, seven dental, three veterinary, and zero physical therapy students; and two studies had heterogeneous populations. Studies represented data from 26,200 students from 29 countries. The prevalence of somatization ranged from 5.7% to 85.2% with a weighted average of 34.4%. Commonly reported somatic symptoms were insomnia, temporomandibular disorder, and musculoskeletal pain. Seventeen studies included an intervention aimed at improving somatization or associated mental and physical health outcomes. Twenty different direct somatization outcome measures were used, and we review them based on validity and reliability.

Somatic symptoms were highly prevalent in all assessed health professions and primary articles reported them to be strongly correlated with mental distress. Further research is necessary, particularly in the U.S., which now claims just five primary articles in the past three decades. Research on non- medical health profession students is particularly lacking, as are controlled trials and research examining the effects of somatic symptoms of stress on long-term quality of life and career attrition from the healthcare field.