Somatization in the population: From mild bodily misperceptions to disabling symptoms

Department of Clinical Psychology, University of Mainz, Staudingerweg 9, 55099 Mainz, Germany.
Social Psychiatry and Psychiatric Epidemiology (Impact Factor: 2.54). 10/2006; 41(9):704-12. DOI: 10.1007/s00127-006-0082-y
Source: PubMed


This study investigates the prevalence of current somatization in the population by taking different levels of symptom severity into account. Somatization is described along a continuum from mild and negligible bodily misperceptions to severe and disabling somatoform symptoms.
A representative sample of 2.552 persons in Germany was examined with a screening instrument for medically unexplained physical complaints that had occurred during the past 7 days. All 53 symptoms from the ICD-10/DSM-IV sections of somatoform disorders were included.
81.6% reported at least one symptom causing at least mild impairment and 22.1% at least one symptom causing severe impairment. The entire sample had an average of 6.6 symptoms associated with at least mild distress. Somatization of any degree was associated with female gender, age above 45, lower educational level, lower household income and rural area. The most common symptoms with prevalence rates > 20% were various types of pain (back, head, joints, extremities), food intolerance, sexual indifference, painful menstruations and erectile/ejaculatory dysfunction.
This population survey demonstrates that medically unclear complaints are an everyday phenomenon. About three out of four cases are below clinical relevance with only low level of impairment. Epidemiological correlates are similar between clinical and non-clinical forms of somatization.

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    • "First, we extend the diagnostic spectrum by including somatoform disorders. This addition is stimulated by a substantial amount of literature highlighting that somatoform disorders like somatization and pain disorders are particularly impairing and with a frequently chronic course with a substantially degree of help-seeking, utilization of health services and high cost burden [4] [14] [16] [15] [32]. Second, we provide a more comprehensive characterization of disability days. "
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    ABSTRACT: This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL). Results are based on a nationally representative sample (DEGS1-MH; n=4483 aged 18-79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (=active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (=unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12months (=non-active cases [NAC]; partially or fully remitted). In comparison to UAI (mean: 1.9), AC reveals a 2-3 fold disability days/month (5.4, P<.001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P<.001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P<.001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases. By and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days. Copyright © 2015. Published by Elsevier Masson SAS.
    European Psychiatry 07/2015; 30(6). DOI:10.1016/j.eurpsy.2015.06.003 · 3.44 Impact Factor
    • "We found no difference in prevalence rates of MUS between younger and older persons, in contrast with many studies reporting on decreasing levels of MUS with increasing age (Hiller et al., 2006; Hilderink et al., 2012). Nonetheless, the only study describing prevalence rates for MUS above the age of 65 that applied similar methodology by using the CIDI reported only a mild decrease of MUS above the age of 65 (Leiknes et al., 2007). "
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    ABSTRACT: Background Physical symptoms significantly impair health-related quality of life (HRQoL), but age effects and differential effects of medically unexplained symptoms (MUS) and medically explained symptoms (MES) have hardly been examined. Our objective was to determine the effect of age on the impact of MUS and MES on HRQoL.Methods In a population-based cohort (n = 946, aged 28–75 years), MUS and MES were measured using the Composite International Diagnostic Interview and HRQoL using the EuroQol-5 dimensions (EQ-5D). Using multiple linear regression, we regressed MUS, MES and their interaction with age on HRQoL, adjusted for socio-demographic variables and the presence of depressive and anxiety disorders. In case of significant interaction terms, age-stratified results will be presented.ResultsIn the whole study population, the association between MUS and HRQoL was stronger (β = −0.35; p < 0.001) than between MES and HRQoL (β = −0.26; p < 0.001). Adjusted for depressive and anxiety disorders, differences between these associations decline (MUS: β = −0.28, p < 0.001; MES: β = −0.25, p < 0.001). Age significantly interacted with number of MUS in explaining variance in HRQoL but not with the number of MES. The impact of MUS on HRQoL is much larger in people aged below 65 years (β = −0.39, p < 0.001) versus those aged 65 years and over (β = −0.21, p = 0.002). In the older group, the association between MUS and HRQoL lost significance when adjusted for depressive and anxiety disorders (β = −0.12 p = 0.062).Conclusion Our results show that age affects the association between MUS and HRQoL, which suggest that older persons cope better with MUS than younger persons. Copyright © 2014 John Wiley & Sons, Ltd.
    International Journal of Geriatric Psychiatry 10/2014; 30(7). DOI:10.1002/gps.4219 · 2.87 Impact Factor
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    • "Lastly, ED may represent a frequent symptom in somatization disorders, especially in men of over 45 years old [61]. "
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    International Journal of Endocrinology 03/2014; 2014(10):878670. DOI:10.1155/2014/878670 · 1.95 Impact Factor
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