Somatisation in primary care in Spain: I. Estimates of prevalence and clinical characteristics. Working Group for the Study of the Psychiatric and Psychosomatic Morbidity in Zaragoza.

Abstract

This is the first attempt to study the prevalence and clinical characteristics of somatisation (ST) in a representative primary care sample in Spain. The sample consisted of 1559 consecutive patients attending eight randomly selected health centres in Zaragoza, Spain, examined by two-phase screening. First phase (lay interviewers): Spanish versions of GHQ-28, CAGE questionnaire, substance abuse, Mini-Mental State Examination. Second phase (research clinicians and psychiatrists): Standardised Polyvalent Psychiatric Interview, which permits the reliable coding of Bridges & Goldberg's ST criteria. The prevalence of somatisers was 9.4% (34.5% of the cases) and most patients (68.7%) were diagnosed in the depression or anxiety DSM-IV categories. The severity was moderate in 401% and 66.6% were chronic (six or more months). No significant demographic differences were found with non-cases. Backache was the most frequent somatic presentation (71.4+%). ST in primary care is a much broader phenomenon than categories such as somatoform disorders reflect. It may be less influenced by sociodemographic factors, but more chronic than previously reported.