Whether medically unexplained or not, three or more concurrent somatic symptoms predict psychopathology and service use in community populations

J Psychosom Res. 2010 Jul;69(1):1-8. doi: 10.1016/j.jpsychores.2010.01.001. Epub 2010 Feb 16.


Objectives: To examine the frequency of somatic symptoms in a community population of various ethnic backgrounds and to identify correlates of these symptoms such as psychopathology, use of services, and personal distress.

Methods: Using a 14-symptom inventory with interviewer probes for somatic symptoms, we determined the presence of general physical symptoms (GPS) in a sample of 4864 white, Latino, and Asian US community respondents. Medically "edited" verbatim interview responses were used to decide whether or not physical symptoms would qualify as medically unexplained physical symptoms (MUPS). We then assessed the association between GPS and MUPS and psychiatric disorders, psychological distress, and use of services, in both unadjusted and multivariate regression analyses.

Results: One-third (33.6%) of the respondents reported at least one GPS and 11.1% reported at least one MUPS within the last year. 10.7% of respondents had three or more GPS and 1.5% had three or more MUPS. Three or more GPS and MUPS were positively associated with depressive, anxiety, and substance use disorders; service use; and psychological distress in unadjusted comparisons. In multivariate regressions, GPS persisted as a significant predictor, but there was no significant independent effect of MUPS, after controlling for GPS and other covariates.

Conclusions: Regardless of the presence or absence of medical explanations, physical symptoms are an important component of common mental disorders such as depression and anxiety and predict service use in community populations. These results suggest that three or more current GPS can be used to designate a "case" and that detailed probes and procedures aimed at determining whether or not physical symptoms are medically unexplained may not be necessary for classification purposes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / ethnology
  • Anxiety Disorders / psychology
  • Asian Americans / psychology*
  • Asian Americans / statistics & numerical data
  • Community Health Services / statistics & numerical data*
  • Comorbidity
  • Cross-Cultural Comparison*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / ethnology
  • Depressive Disorder / psychology
  • European Continental Ancestry Group / psychology*
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Hispanic Americans / psychology*
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Mental Disorders / ethnology
  • Mental Disorders / psychology*
  • Middle Aged
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / epidemiology*
  • Somatoform Disorders / ethnology
  • Somatoform Disorders / psychology*
  • Statistics as Topic
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / ethnology
  • Substance-Related Disorders / psychology
  • Utilization Review
  • Young Adult