SOMATIZATION DISORDER IN PRIMARY HEALTH-C ARE - DIFFERENTIAL CLINICALCHARACTERISTICS

BACKGROUND: TO identify specific sociodemographic and psychopathologic al features of somatization disorder (SD) patients in relation to othe r patients with psychiatric and organic morbidity in primary care (PC) setting. METHODS: A group Of SD patients from PC was compared with ot her two control groups: the first one made of patients with psychiatri c morbidity (with or without organic disease) and the second group of patients with only organic disease without psychiatric morbidity. Poli valent standarized psiquiatric interview (PSPI), a specific psychiatri c interview for PC settings, was used as diagnostic instrument. RESULT S: 1) there is a female predominance in SD statisticaly significant co mpared with organic patients and with a trend to significance in relat ion to psychiatric patients. Age, marital status and educational level show no significant differences among the groups; 2) in relation to p sychopatology, SD patients show, in relation with organic patients, st atistically higher levels in all items measured by PSPI. On the contra ry, SD overwhelmed psychiatric patients in just four items: somatic sy mptoms, fatigue, reported anxiety and hystrionism as well as sexual pr oblems and lack of social support, and 3) high psychiatric morbidity ( 85%) in SD, most of them affective and anxiety diagnosis, make it diff icult to differentiate from the other patients suffering from psychiat ric morbidity in PC. CONCLUSION: Patients with SD show a very differen t profile compared with those with organic disease in relation to psyc hiatric symptoms and social problems. On the other hand, when compared with patients with psychiatric disorders, differences are rather scar ce. In addition, affective and anxiety comorbidity associated make it difficult the diagnosis. For this reason, the use of screening instrum ents for SD seems mandatory.