Although somatoform disorders are assumed to be chronic clinical conditions, epidemiological knowledge on their natural course based on representative samples is not available.

Data come from a prospective epidemiologic study of adolescents and young adults in Munich, Germany. Respondents’ diagnoses (N = 2548) at baseline and follow-up on average 42 months later are considered. The follow-up incidence, stability as well as selected baseline risk factors (sociodemographics, psychopathology, trauma exposure) for the incidence and stability of somatoform disorders and syndromes are prospectively examined. Diagnostic information was assessed by using the standardized Munich-Composite International Diagnostic Interview (M-CIDI).

Over the follow-up period, incidence rate for any of the covered somatoform diagnoses was 25.7%. Stability for the overall group of any somatoform disorder/syndrome was 48%. Female gender, lower social class, the experience of any substance use, anxiety and affective disorder as well as the experience of traumatic sexual and physical threat events predicted new onsets of somatoform conditions, while stability was predicted by being female, prior existing substance use, affective and eating disorders as well as the experience of a serious accident.

At least for a substantial proportion of individuals, the overall picture of somatization seems to be relatively stable, but with fluctuation in the symptom picture over time. Being female, the experience of substance use as well as anxiety disorder seem to constitute risk factors for the onset of new somatoform conditions as well as for a stable course over time.

This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL).

Results are based on a nationally representative sample (DEGS1-MH; n = 4483 aged 18–79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4 weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (= active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (= unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12 months (= non-active cases [NAC]; partially or fully remitted).

In comparison to UAI (mean: 1.9), AC reveals a 2–3 fold disability days/month (5.4, P < .001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P < .001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P < .001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases.

By and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days.

Although positive effects of physical activity on mental health indicators have been reported, the relationship between physical activity and the development of specific mental disorders is unclear.

A cross-sectional (12-month) and prospective-longitudinal epidemiological study over 4 years in a community cohort of 2548 individuals, aged 14–24 years at outset of the study. Physical activity and mental disorders were assessed by the DSM-IV Composite International Diagnostic Interview (CIDI) with an embedded physical activity module. Multiple logistic regression analyses controlling for age, gender and educational status were used to determine the cross-sectional and prospective associations of mental disorders and physical activity.

Cross-sectionally, regular physical activity was associated with a decreased prevalence of any and co-morbid mental disorder, due to lower rates of substance use disorders, anxiety disorders and dysthymia. Prospectively, subjects with regular physical activity had a substantially lower overall incidence of any and co-morbid mental disorder, and also a lower incidence of anxiety, somatoform and dysthymic disorder. By contrast, the incidence of bipolar disorder was increased among those with regular physical activity at baseline. In terms of the population attributable fraction (PAF), the potential for preventive effects of physical activity was considerably higher for men than for women.

Regular physical activity is associated with a substantially reduced risk for some, but not all, mental disorders and also seems to reduce the degree of co-morbidity. Further examination of the evidently complex mechanisms and pathways underlying these associations might reveal promising new research targets and procedures for targeted prevention.

Aunque se supone que los trastornos somatomorfos son cuadros clínicos crónicos, no se dispone de conocimiento epidemiológico sobre su curso natural basado en muestras representativas.

Los datos proceden de un estudio epidemiológico prospectivo de adolescentes y adultos jóvenes en Munich, Alemania. Se considera los diagnósticos de los respondientes (n = 2.548) en la línea base y en el seguimiento realizado 42 meses después como media. Se examina prospectivamente la incidencia en el seguimiento, la estabilidad y además factores de riesgo (sociodemográficos, manifestaciones psicopatológicas, exposición a traumas) seleccionados de la línea de base para la incidencia y la estabilidad de los trastornos y síndromes somatomorfos. La información diagnóstica se evaluó utilizando la Entrevista Diagnóstica Internacional Compuesta - Munich (M-CIDI) estandarizada.

Durante el periodo de seguimiento, la tasa de incidencia para cualquiera de los diagnósticos somatomorfos cubiertos fue 25,7%. La estabilidad para el grupo total de cualquier trastorno/síndrome somatomorfo fue 48%. El género femenino, la clase social baja, la experiencia de uso de cualquier sustancia, el trastorno de ansiedad y el afectivo, así como la experiencia de acontecimientos traumáticos de amenaza sexual y física predecían nuevos comienzos de afecciones somatomorfas, mientras que ser mujer, la existencia de uso anterior de sustancias, los trastornos afectivos y de la conducta alimentaria así como la experiencia de un accidente grave predecían la estabilidad.

Al menos para una proporción sustancial de individuos, el cuadro global de la somatización parece ser relativamente estable, pero con fluctuación en el cuadro de síntomas con el tiempo. Ser mujer, la experiencia de uso de sustancias así como el trastorno de ansiedad parecen constituir factores de riesgo para el comienzo de nuevas afecciones somatomorfas lo mismo que para un curso estable en el tiempo.