SOMATIZATION IN FREQUENT ATTENDERS OF GENERAL-PRACTICE

The DSM-III-(R) definition of somatization disorder is too restrictive for use in general practice. A more comprehensive definition, the ''s omatic symptom index'' (SSI) has shown good validity in open populatio ns. However, a definition has to differentiate validly within a popula tion of frequent attenders to be a useful diagnostic instrument in gen eral practice. We studied a threshold of five complaints (nearly ident ical to the SSI) in 80 Dutch general practice patients. Patients were selected on age (20-44 years), history of back, neck or abdominal comp laints, and on frequency of consultation-at least 12 consultations in the previous 3 years, corrected for consultations with compelling soma tic reason for encounter. Prevalence of somatization in this group was 45%. Women had a 2 times higher risk of somatization. A relation with age was not found. Somatization was related to depressive complaints (relative risk 2.5) and probably also to anxiety. Somatizing patients consulted their general practitioner more often and had more health pr oblems (especially psychic problems) than non-somatizers. These result s support the validity of this definition. The distinction between our definition of somatization and somatization defined as a symptom of p sychiatric (e.g. depressive or anxiety) disorder is emphasized.