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From the Roseneck Center for Behavioral Medicine, Prien, (W.R.); and University of Leipzig, Clinic of Psychotherapy and Psychosomatic Medicine (A.H.) and Department of Medical Psychology (E.B.), Leipzig, Germany.
Address reprint requests to: Dr. W. Rief, University of Marburg, FB 04, Gutenberg str. 18, D-35032 Marburg, Germany. Email: RIEF{at}mailer.uni-marburg.de
OBJECTIVE: The principal goal of this study is to examine the base rates of somatoform symptoms and of hypochondriacal features in the general population.
METHODS: A representative sample of 2050 persons in Germany was examined by use of screening for somatoform symptoms and the Whiteley Index.
RESULTS: The most frequent somatoform symptoms were back pain, joint pain, pain in extremities, and headache, as well as abdominal symptoms (bloating or intolerance of several foods) and cardiovascular symptoms (palpitation). People reported a mean of two somatization symptoms of DSM-IV somatization disorder (SD) during the prior 2 years. Strong age and medium gender effects were found for most somatoform symptoms, as well as for composite indices. However, the sex ratio suggested in DSM-IV for SD seems to be an overestimation. Hypochondriacal features showed only small sex differences but, again, pronounced age effects. In contrast to low rates for SD, the base rates for somatization and hypochondriacal features were high and represented the health care relevance of subthreshold syndromes.
CONCLUSION: We present base rates of hypochondriacal and somatization features that may be important facets in the development of classification criteria and in the interpretation of health care expenditure.
Key Words: somatization • hypochondriasis • Whiteley Index • general population • gender differences
Abbreviations: SOMS = Screening for Somatoform Symptoms; WI = Whiteley-Index; SSI = Somatic Symptom Index; PSS = polysymptomatic somatization disorder; SAD = somatoform autonomic dysfunction; SD = somatization disorder; DSM-III-R = Diagnostic and Statistical Manual of Mental Disorders, third edition, revised; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, fourth edition; ICD-10 = International Classification of Diseases, 10th revision.
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