SOMATIZATION IN PRIMARY-CARE IN SPAIN .2. DIFFERENCES BETWEEN SOMATISERS AND PSYCHOLOGISERS

Background. This study is the first attempt to document the difference s between somatisers (STs) and psychologisers (PGs) in Spanish primary care patients. Method. A sample of 1559 consecutive patients attendin g eight randomly selected health centres in Zaragoza, were examined in a two-phase screening using Spanish versions of GHQ-28, CAGE question naire, substance abuse, MMSE and SPPI. STs and PGs were diagnosed acco rding to operationalised Bridges & Goldberg's criteria. Results. ST wa s found to be three times more prevalent than PG, but the ratio ST: PG was highest (10.5) in the DSM-IV category dysthymia. Generalised anxi ety disorder was the most frequent diagnosis in STs and major depressi ve episode the most frequent in PGs. No significant differences betwee n the two groups have been found in demographic characteristics. Total GHQ scores were significantly higher in PGs, but global SPPI scores w ere not. Most psychopathological scores were higher in PGs, but both s omatic symptoms and suspiciousness were higher in STs. The psychopatho logical findings are consistent with hypotheses related to blame avoid ance and defensiveness in STs. Conclusions. ST is three times more pre valent than PG, but the ratio ST: PG depends heavily on diagnostic cat egories. While most psychopathological scores are higher in PGs, both patient groups are similarly disturbed. Previously assumed socio-demog raphic differences between STs and PGs have not been found in this stu dy.