Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-06-18T21:15:50.091Z Has data issue: false hasContentIssue false

Gender and cross-cultural differences in somatic symptoms associated with emotional distress. An international study in primary care

Published online by Cambridge University Press:  01 March 1997

MARCO PICCINELLI
Affiliation:
Servizio di Psicologia Medica, Istituto di Psichiatria, Università di Verona, Italy; and Center for Health Studies, Group Health Cooperative, Seattle, WA, USA
GREGORY SIMON
Affiliation:
Servizio di Psicologia Medica, Istituto di Psichiatria, Università di Verona, Italy; and Center for Health Studies, Group Health Cooperative, Seattle, WA, USA

Abstract

Background. Gender and cross-cultural differences in the association between somatic symptoms and emotional distress were investigated, using data from the World Health Organization Collaborative Project on Psychological Problems in General Health Care.

Methods. Data were collected at 15 centres in 14 countries around the world. At each centre, a stratified random sample of primary care attenders aged 15–65 years was assessed using, among other instruments, the 28-item General Health Questionnaire and the Composite International Diagnostic Interview-Primary Health Care Version.

Results. Females reported higher levels of somatic symptoms and emotional distress than males. A strong correlation between somatic symptoms and emotional distress was found in both sexes, with females reporting more somatic symptoms at each level of emotional distress. However, linear regression analysis showed that gender had no significant effect on level of somatic symptoms, when the effects of centre and emotional distress were controlled for. In both sexes, no specific pattern of association emerged between somatic symptom clusters and either anxiety or depression. Primary care attenders from less developed centres reported more somatic symptoms and showed greater gender differences than individuals from more developed centres, but inter-centre differences were small. Finally, gender was not a significant predictor of reason for consultation (somatic versus mental/behavioural symptoms), after controlling for levels of somatic symptoms and emotional distress as well as for centre effect.

Conclusions. These data do not support the common belief that females somatize more than males or the traditional view that somatization is a basic orientation prevailing in developing countries. Instead, somatic symptoms and emotional distress are strongly associated in primary care attenders, with few differences between the two sexes and across cultures.

Type
Research Article
Copyright
© 1997 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)