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Somatisation in Primary Care in Spain

II. Differences between Somatisers and Psychologisers

Published online by Cambridge University Press:  02 January 2018

Javier García-Campayo ,
Ricardo Campos ,
Guillermo Marcos ,
Ma Jesus Peréz-Echeverría ,
Antonio Lobo  and
the GMPPZ
Javier García-Campayo
Affiliation:
Departamento de Psiquiatrìa, Facultad de Medicina y Hospital Clínico Universitario, Zaragoza
Ricardo Campos
Affiliation:
Psiquiatrìa, Hospital Miguel Servet, Zaragoza
Guillermo Marcos
Affiliation:
Psiquiatrìa, Hospital Clínico Universitario, Zaragoza
Ma Jesus Peréz-Echeverría
Affiliation:
Departamento de Medicina Social y Preventiva, Facultad de Medicina y Hospital Clínico Universitario, Zaragoza
Antonio Lobo*
Affiliation:
Psiquiatrìa, Hospital Miguel Servet, Zaragoza
*
Antonio Lobo, Servicio de Psiquiatrìa, Planta 11, Hospital Clinico Universitario, 50.009 Zaragoza, Spain
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Abstract

Background

This study is the first attempt to document the differences between somatisers (STs) and psychologisers (PGs) in Spanish primary care patients.

Method

A sample of 1559 consecutive patients attending eight randomly selected health centres in Zaragoza, were examined in a two-phase screening using Spanish versions of GHQ–28, CAGE questionnaire, substance abuse, MMSE and SPPI. STs and PGs were diagnosed according to operationalised Bridges & Goldbergs criteria.

Results

ST was found to be three times more prevalent than PG, but the ratio ST: PG was highest (10.5) in the DSM–IV category dysthymia. Generalised anxiety disorder was the most frequent diagnosis in STs and major depressive episode the most frequent in PGs. No significant differences between the two groups have been found in demographic characteristics. Total GHQ scores were significantly higher in PGs, but global SPPI scores were not. Most psychopathological scores were higher in PGs, but both somatic symptoms and suspiciousness were higher in STs. The psychopathological findings are consistent with hypotheses related to blame avoidance and defensiveness in STs.

Conclusions

ST is three times more prevalent than PG, but the ratio ST: PG depends heavily on diagnostic categories. While most psychopathological scores are higher in PGs, both patient groups are similarly disturbed. Previously assumed socio-demographic differences between STs and PGs have not been found in this study.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue 3 , March 1996 , pp. 348 - 353
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Altisent, R. (1986) La detección precoz de la enfermedad alcohólica: cuestionarios CAGE y CBA frente a marcadores biológicos. Doctoral Thesis. University of Zaragoza, Spain.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington DC: APA.Google Scholar
Barsky, A. J. & Klerman, G. L. (1983) Overview: hypochondriasis, bodily complaints and somatic styles. American Journal of Psychiatry, 140, 273–283.Google Scholar
Bridges, K. W. & Goldberg, D. P. (1985) Somatic presentation of DSM III psychiatric disorders in primary care. Journal of Psychosomatic Research, 29, 563–569.CrossRefGoogle Scholar
Bridges, K. W., Goldberg, D. P., Evans, B., et al (1991) Determinants of somatization in primary care. Psychological Medicine, 21, 473–483.Google Scholar
Escobar, J. I., Burnam, A., Karno, M., et al (1987) Somatization in the community. Archives of General Psychiatry, 44, 713–718.Google Scholar
Escobar, J. I., Rubio-Stipec, M., Canino, G., et al (1989) Somatic Symptom Index (SSI): a new and abridged somatization construct. Journal of Nervous and Mental Disorders, 177, 140–146.Google Scholar
Ewing, J. A. (1984) Detecting alcoholism: the CAGE questionnaire. Journal of the American Medical Association, 252, 1905–1907.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) ‘Mini-Mental State’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Goldberg, D. & Hillier, V. F. (1979) A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.CrossRefGoogle Scholar
Goldberg, D. & Bridges, K. (1988) Somatic presentation of psychiatric illness in primary care settings. Journal of Psychosomatic Research, 32, 137–144.Google Scholar
Kellner, R. (1990) Somatization: theories and research. The Journal of Nervous and Mental Disease, 178, 150–160.CrossRefGoogle Scholar
Kirmayer, L. J. & Robbins, J. M. (1991) Three forms of somatization in primary care: prevalence, co-occurrence and sociodemographic characteristics. Journal of Nervous and Mental Disease, 179, 647–655.Google Scholar
Goldberg, D., Goldberg, D., Dworkind, M., et al (1993) Somatization and the recognition of depression and anxiety in primary care. American Journal of Psychiatry, 150, 734–741.Google Scholar
Kleinman, A. (1977) Depression, somatization and the ‘new cross-cultural psychiatry’. Social Science and Medicine, 11, 3–10.Google Scholar
Kleinman, A. & Kleinman, J. (1985) Somatization: the interconnections in Chinese society among culture, depressive experiences and meaning of pain. In Culture and Depression: Studies in the Anthropology and Cross Culture Psychiatry of Affect and Disorder (eds Kleinman, A. & Good, B.), pp. 429–490. Berkely, CA: University of California Press.Google Scholar
Lecompte, D. (1989) Psychotherapy in non-organic somatization: a comparative study. European Journal of Psychiatry, 3, 82–90.Google Scholar
Lipowski, Z. J. (1988) Somatization: the concept and its clinical application. American Journal of Psychiatry, 145, 1358–1368.Google Scholar
Lobo, A., Ezquerra, F., Gomez, F., et al (1979) El Mini-Examen Cognoscitivo: un test sencillo, práctico, para detectar alteraciones intelectuales en pacientes médicos. Actas Luso-Españolas de Neurología, Psiquiatría y Ciencias Afines, VII, 189–202.Google Scholar
Kleinman, A., Pérez-Echeverria, M. J. & Artal, J. (1986) Validity of the scaled version of the General Health Questionnaire (GHQ–28) in a Spanish population. Psychological Medicine, 16, 135–140.Google Scholar
Kleinman, A., Campos, R., Perez-Echeverria, M. J., et al (1993) A new interview for the multiaxial assessment of psychiatric morbidity in medical settings. Psychological Medicine, 23, 505–510.Google Scholar
Mayfield, D., McLeod, G. & Hall, P. (1974) The CAGE questionnaire: validation of a new alcoholism screening instrument. American Journal of Psychiatry, 131, 1121–1123.Google Scholar
Rosen, G., Kleinman, A. & Katon, W. (1982) Somatization in family practice: a biopsychosocial approach. Journal of Family Practice, 14, 493–502.Google Scholar
Slavney, P. R., Teitelbaum, M. L. & Chang, G. A. (1985) Referral for medically unexplained somatic complaints: the role of histrionic traits. Psychosomatics, 26, 103–109.CrossRefGoogle Scholar
Wright, A. F. (1990) A study of the presentation of somatic symptoms in general practice by patients with psychiatric disturbance. British Journal of General Practice, 40, 459–463.Google Scholar
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