Somatization in the Community

Escobar, Javier I.; Burnam, M. Audrey; Karno, Marvin; Forsythe, Alan B.; Golding, Jacqueline M.

doi:10.1001/archpsyc.1987.01800200039006

Cited by 401 publications

(156 citation statements)

References 30 publications

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“…SD is a chronic, disabling syndrome presenting a facade of physical symptoms associated with significant psychopathology and functional disability. Individuals with SD tend to seek care in general medicine or specialty medical settings in lieu of seeking mental health services (Escobar et al 1987;Swartz et al 1991). According to several studies, SD is a rare diagnosis in the general population (Swartz et.…”

Section: Somatization Disordermentioning

confidence: 99%

“…Our clinical and research observations (Escobar et al 1987) led us to view the functional somatic syndromes as existing on a continuum ranging from few medically unexplained symptoms to many, with SD itself placed at the extreme of this frequency/ severity spectrum. In our current thinking, any given cluster of medically unexplained physical symptoms may have distinctive qualitative elements; hence the underlying taxonomic model may very well be a hybrid model, including dimensional features as well as discontinuities.…”

Section: From the Categorical To The Dimensional: Abridged Somatizationmentioning

confidence: 99%

“…In the late 1980s we proposed an abridged construct of somatization for identifying cases, by demonstrating that lowering the threshold for somatization to four and six symptoms for males and females, respectively, increased the prevalence rate of somatization cases 100-fold relative to the full diagnosis of SD, while still predicting all relevant outcomes (use of services, disability, psychopathology) (Escobar et al 1987). Originally, the abridged somatization construct was operationalized in terms of the 37 somatic symptoms included in the Diagnostic Interview Schedule (DIS) (Robins et al 1981).…”

Section: From the Categorical To The Dimensional: Abridged Somatizationmentioning

confidence: 99%

See 2 more Smart Citations

Medically unexplained physical symptoms in medical practice: a psychiatric perspective.

Escobar

Hoyos-Nervi

Gara

2002

Environ Health Perspect

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Section: Somatization Disordermentioning

confidence: 99%

Section: From the Categorical To The Dimensional: Abridged Somatizationmentioning

confidence: 99%

Section: From the Categorical To The Dimensional: Abridged Somatizationmentioning

confidence: 99%

See 1 more Smart Citation

Medically unexplained physical symptoms in medical practice: a psychiatric perspective.

Escobar

Hoyos-Nervi

Gara

2002

Environ Health Perspect

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“…Escobar et al introduced the ''Somatic Symptom Index'' in 1989 [53,54]. This index defines somatization for men and women separately as four and six or more symptoms from a list of 37 symptoms derived from the American Diagnostic and Statistical Manual of Mental Disorders (DSM-III).…”

Section: (B) Functional Somatizationmentioning

confidence: 99%

Somatization, heartsink patients, or functional somatic symptoms? Towards a clinical useful classification in primary health care

Rosendal

Fink

Bro

et al. 2005

Scandinavian Journal of Primary Health Care

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Several definitions of somatization exist and try to deal with the fundamental problem that a large group of patients present with physical symptoms for which a conventional pathology cannot be identified. However, the concept remains somewhat confusing. The prevalence of somatization is high in general practice. Nevertheless, patients do not receive proper treatment and risk iatrogenic somatic fixation and harm, the doctor Á/patient relationship is often negatively affected and the overall healthcare system suffers from high expenditure on unnecessary physical investigations and treatments. During the last decade research has shown that somatization may be treated effectively in specialist care. Little is known about effective treatment in primary care but the Reattribution Model and the Extended Reattribution and Management Model have shown promising results. The development and evaluation of new treatment strategies is, however, hampered by the confusion of definitions and concepts. In this article an overview is presented of the various concepts relevant to the clinical work and research in primary health care. It is important to realize that somatizing patients in primary health care present a broader spectrum of severity than patients seen in a specialist setting. Hence, primary care cannot apply definitions from specialist care directly but needs a definition that also includes the mild cases. We need classifications and agreed definitions applicable in primary health care in order to develop appropriate management strategies, to predict prognosis, and to enable rigorous research concerning the large group of somatizing patients in primary health care.

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“…Questo possibile vantaggio e tuttavia controbilanciato dal fatto che i pazienti che somatizzano il proprio disagio psichico tendono ad avere disturbi che durano piu a lungo, consultano piu frequentemente i servizi sanitari ed assumono piu spesso farmaci, soprattutto analgesici (Huxley & Goldberg, 1975;Katon et al, 1984;Escobar et al, 1987).…”

Section: Motivo Principale Della Consultazioneunclassified

Lo studio internazionale multicentrico dell'Organizzazione Mondiale della Sanità sui disturbi psichici nella medicina generale: risultati relativi all'area di Verona

Piccinelli

Pini

Bellantuono

et al. 1995

Epidemiol Psichiatr Soc

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Riassunto.Obiettivi -Presentare i risultati emersi dalla valutazione trasversale di un campione di soggetti selezionato negli ambulatori di medicina generale dell'area di Verona nel corso dello studio internazionale multicentrico dell'Organizzazione Mondiale della Sanita sui disturbi psichici nella medicina generale. Metodo -Tra coloro che si erano rivolti consecutivamente agli ambulatori di 16 medici di base nel periodo aprile 1991/febbraio 1992, e stato selezionato un campione randomizzato di soggetti, stratificato sulla base del punteggio riportato al GHQ-12, da sottoporre ad un'approfondita valutazione dello stato psicopatologico, dello stato di salute fisica e dei livelli di disability in campo occupazionale e nelle altre attivita quotidiane. Tutti i pazienti che alia valutazione iniziale presentavano sintomi psicopatologici ed un campione di soggetti pari al 20% di coloro che non presentavano sintomi psicopatologici sono stati rivalutati a distanza di 3 mesi e poi ancora di un anno (dati non presentati in questa sede). Risultati -In totale, dei 1.656 soggetti contattati dai ricercatori negli ambulatori di medicina generale, 1.625 soddisfacevano i requisiti richiesti per essere inclusi nello studio. La procedura di screening e stata completata da 1.558 soggetti e la valutazione del secondo stadio da 250. Disturbi psichici secondo i criteri dell'ICD-10 erano presenti nel 12.4% dei soggetti che avevano contattato consecutivamente gli ambulatori di medicina generale e, di questi, un terzo circa (4.5% dei soggetti sottoposti inizialmente a screening) soddisfaceva i criteri diagnostici per la presenza contemporanea di due o piu disturbi psichici diversi. Le diagnosi di Episodio Depressivo Attuale (4.7%) e quella di Sindrome Ansiosa Generalizzata (3.7%) sono risultatele piu frequenti. Un ulteriore 11.2% dei soggetti selezionati presentava disturbi psichici 'sotto la soglia' (cosi definiti sulla base della presenza di sintomi in almeno due aree sintomatologiche distinte tra quelle previste dalle singole categorie diagnostiche delFICD-10, senza che venissero perd soddisfatti tutti i criteri diagnostici per la presenza del disturbo in esame). I disturbi psichici sono risultati piu frequenti tra le donne e nella classe di eta compresa tra 25 e 44 anni. Solamente il 20.6% dei soggetti con

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Somatization in the Community

Cited by 401 publications

References 30 publications

Medically unexplained physical symptoms in medical practice: a psychiatric perspective.

Medically unexplained physical symptoms in medical practice: a psychiatric perspective.

Somatization, heartsink patients, or functional somatic symptoms? Towards a clinical useful classification in primary health care

Lo studio internazionale multicentrico dell'Organizzazione Mondiale della Sanità sui disturbi psichici nella medicina generale: risultati relativi all'area di Verona

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