PATIENTS WHO SOMATIZE IN PRIMARY-CARE - A LONGITUDINAL-STUDY OF COGNITIVE AND SOCIAL CHARACTERISTICS

We examined the cognitive and sociodemographic characteristics of pati ents making somatic presentations of depression and anxiety in primary care. only 15% of patients with depressive symptomatology on self-rep ort, and only 21% of patients with current major depression or anxiety disorders on diagnostic interview, presented psychosocial symptoms to their GP. The remainder of patients with psychiatric distress present ed exclusively somatic symptoms and were divided into three groups - i nitial, facultative and true somatizers - based on their willingness t o offer or endorse a psychosocial cause for their symptoms. Somatizers did not differ markedly from psychologizers in sociodemographic chara cteristics except for a greater proportion of men among the true somat izers. Compared to psychologizers, somatizers reported lower levels of psychological distress, less introspectiveness and less worry about h aving an emotional problem. Somatizers were also less likely to attrib ute common somatic symptoms to psychological causes and more likely to endorse normalizing causes. In the 12 months following their initial visit, somatizers made less use of speciality mental health care and w ere less likely to present emotional problems to their GP. Somatizers were markedly less likely to talk about personal problems to their GP and reported themselves less likely to seek help for anxiety or sadnes s. Somatization represents a persistent pattern of illness behaviour i n which mental health care is not sought despite easily elicited evide nce of emotional distress. Somatization is not, however, associated wi th higher levels of medical health care utilization than that found am ong patients with frank depression or anxiety.