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Somatization in frequent attenders of general practice

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Abstract

The DSM-III-(R) definition of somatization disorder is too restrictive for use in general practice. A more comprehensive definition, the “somatic symptom index” (SSI) has shown good validity in open populations. However, a definition has to differentiate validlywithin a population of frequent attenders to be a useful diagnostic instrument in general practice. We studied a threshold of five complaints (nearly identical to the SSI) in 80 Dutch general practice patients. Patients were selected on age (20–44 years), history of back, neck or abdominal complaints, and on frequency of consultation—at least 12 consultations in the previous 3 years, corrected for consultations with compelling somatic reason for encounter. Prevalence of somatization in this group was 45%. Women had a 2 times higher risk of somatization. A relation with age was not found. Somatization was related to depressive complaints (relative risk 2.5) and probably also to anxiety. Somatizing patients consulted their general practitioner more often and had more health problems (especially psychic problems) than non-somatizers. These results support the validity of this definition. The distinction between our definition of somatization and somatization defined as a symptom of psychiatric (e.g. depressive or anxiety) disorder is emphasized.

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Authors and Affiliations

  1. Section of Social Psychiatry and Psychiatric Epidemiology, Department of Psychiatry and Neuropsychology, University of Limburg, P.O. Box 616, NL-6200 MD, Maastricht, The Netherlands

    P. J. M. Portegijs, I. M. Proot, H. F. Kraan & N. C. H. F. Gunther

  2. Department of General Practice, University of Limburg, Maastricht, The Netherlands

    F. G. van der Horst & J. A. Knottnerus

Authors
  1. P. J. M. Portegijs
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  2. F. G. van der Horst
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  3. I. M. Proot
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  4. H. F. Kraan
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  5. N. C. H. F. Gunther
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  6. J. A. Knottnerus
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Portegijs, P.J.M., van der Horst, F.G., Proot, I.M. et al. Somatization in frequent attenders of general practice. Soc Psychiatry Psychiatr Epidemiol 31, 29–37 (1996). https://doi.org/10.1007/BF00789119

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