Anxiety mediates the impact of stress on psychosomatic symptoms in Chinese

Psychol Health Med. 2015;20(4):457-68. doi: 10.1080/13548506.2014.951372. Epub 2014 Aug 26.


The literature has stipulated that stress causes somatic symptoms; however, the pathway has not been empirically examined. This study examines the relationship between stress, anxiety, depression, and somatic symptoms by investigating the mediating roles of anxiety and depression in the relationship between stress and somatic symptoms in the general Chinese population. Data were collected from 202 Chinese participants in a household survey conducted between August and September 2013 in Hong Kong. The measurements included a Patient Health Questionnaire, Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Sociodemographics. By using structural equation modeling, anxiety was a significant mediator of the effect of stress on somatic symptoms (Z = 4.328, p < .001, 95% CI = .061, .152), even after adjusting for sociodemographic variables. The findings imply that clinical presentation of somatic symptoms will be helpful for general practitioners in primary care in diagnosing anxiety.

Keywords: anxiety; depression; mediator; somatic symptoms; stress.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / psychology*
  • Asian People / psychology*
  • Dizziness / psychology
  • Dyspnea / psychology
  • Female
  • Gastrointestinal Diseases / psychology
  • Hong Kong
  • Humans
  • Male
  • Middle Aged
  • Pain / psychology
  • Somatoform Disorders / psychology*
  • Stress, Psychological / psychology*
  • Young Adult