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Epidemiology of the Association Between Somatoform Disorders and Anxiety and Depressive Disorders: An Update

From the Epidemiology and Health Psychology (R.L.), Institute of Psychology, University of Basel, Basel, Switzerland; Max Planck Institute of Psychiatry (R.L.), Munich, Germany; Clinical Psychology and Psychotherapy (G.M.), Institute of Psychology, University of Basel, Basel, Switzerland; and Academic Unit of Psychiatry (R.A.), University of Bristol, United Kingdom.

Address correspondence and reprint requests to Roselind Lieb, Institute of Psychology, Missionsstrasse 60-62, 4055 Basel, Switzerland. E-mail: roselind.lieb{at}unibas.ch

ABSTRACT

Objective: To review the available epidemiological evidence on associations between somatoform disorders with anxiety and depressive disorders.

Results: Clinical and population-based studies have found that the co-occurrence of some types of somatoform disorders (e.g., somatization disorder, somatic-symptom-index (SSI)4,6, and pain disorder) and anxiety and depressive disorders is common. These findings may suggest either a causal relationship between these disorders or that they share some common etiological factors. For other forms of somatoform disorders, empirical evidence about co-occurrence is even thinner or not available at all, especially from non-western settings.

Conclusion: Some implications of how these findings, or the absence of them, can help us understand better the etiology of somatoform disorders and improve the classification of mental disorders as a whole are discussed.

Key Words: epidemiology • somatoform disorders • emotional disorders • comorbidity

Abbreviations: DSM = Diagnostic and Statistical Manual of Mental Disorders; DIS = Diagnostic Interview Schedule; ECA = Epidemiological Catchment Area Program; FGD = functional gastrointestinal disorders; GAD = general anxiety disorder; OR = odds ratio; PTSD = posttraumatic stress disorder; SSI = Somatic Symptom Index.

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