A Clinical-Psychological Perspective on Somatization Among Immigrants: A Systematic Review

Abstract

Background: Somatic and psychopathological conditions (e.g., anxiety, depression, post-traumatic stress disorder, and somatization) are frequent among immigrants belonging to various ethnic groups. Worldwide findings on the epidemiology regarding specific mental conditions still vary with respect to different migration samples and migration contexts. This inconsistency also holds true in the incidence of somatization among migrants. We carried out a systematic review analyzing the relationship between migration and somatization by providing a qualitative data synthesis of original research articles on the topic.Methods: According to PRISMA guidelines, we conducted a systematic search of the literature on PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect. The articles were selected using multiple combinations of relevant search terms (e.g., defined somatization and related disorders, and migration status). Each database was searched systematically from January 2000 to December 2017.Results: The initial search identified 338 records, of which 42 research reports met the predefined inclusion criteria and were analyzed. Most studies (n = 38; 90%) were cross-sectional. The main findings of this study are that migrants with somatization exhibited more psychological distress, had an increased perceived need for healthcare service utilization, and reported more post-migration living difficulties and/or post-traumatic stress disorder than those without somatization. It was also found that specific individual features mediate the association between somatization and migration. The prevalence and correlates of somatization were found to vary across the immigrant groups, depending on cultural variation in reasons for migration, stress exposure, explanatory models of illness, coping, and other individual variables.Conclusion: Somatization is a challenge for health professionals due to its vague nature. In this regard, clinical management of immigrant patients should include further efforts to address emotional distress, with special attention to social, cultural, and linguistic differences.

Somatic distress among Syrian refugees in Germany: analysis of a cross-sectional register-based study

“…These ndings suggest that somatization may be an important aspect of trauma, one of the greatest causes of emotional distress (28). Evidence con rming this assumption was found in several refugee samples, for example in 128 Somali refugees in Finland or 1147 traumatized refugees in the Netherlands reporting a positive correlation between somatization and the number of previous traumatic events (22,29,30).…”

“…It was striking that the in uence of post-migratory general psychosocial stress on SOD was greater than that of traumatic experiences. All predictors have already been found in different samples of refugees and host countries except for the concept of general psychosocial stress (14,17,22,31). Instead, however, parts of this construct, such as bad economic status, have already been identi ed as risk factors for SOD (31,46).…”

Post-traumatic Stress Disorder Related to Trait Emotional Intelligence of Slovaks in Comparison to Turkish Immigrants in Slovakia

“…Haller, Cramer, Lauche, and Dobos (2015) indicated somatization, including post-traumatic stress disorder (PTSD), in diverse ethnic immigrant groups growing all over the world. The systematic review and a meta-analytical study done by Lanzara, Scipioni, and Conti (2019) reviewing 42 papers published between 2000 and 2017 with 38 cross-sectional analyses disclosed the prevalence and correlates of somatization (including PTSD) across the immigrant groups, depending on cultural variation, in reasons for migration, stress exposure, explanatory models of illness, coping, and other individual variables.…”

“…We presuppose trauma exposure is common throughout the whole world, unequally distributed, and differential across trauma types concerning PTSD risk (Kessler et al, 2017). In the meta-analytical study of 42 research papers, in only four of them was somatization found to be significantly prevalent in immigrants relative to the country's natives (Lanzara et al, 2019). Referring to Turkish population, only a few studies proved psychosomatic prevalence versus the locals.…”

Psychological distress and somatization in immigrants in primary health care practices.

“…A recent systematic review argues that immigrants with somatization disorders perceive a greater need for the use of health services and greater di culties in their daily lives than those who do not have them. However, there are differences in the prevalence of somatization disorders between different groups of immigrants, depending on culture, exposure to stress, explanatory models of the disease, coping and other individual variables (12).…”