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Families who somatize.

This investigation extends a previous study of children of people with somatization disorder and children of less severely affected somatizers. We used the revised Diagnostic Interview for Children and Adolescents, revised, and abstracted medical records to compare families in which a child as well as a parent had unexplained somatic complaints; we also identified parental predictors of children's somatization. Children in families with somatizing children had more emergency room use, more suicidal behavior, and more disability. Children in families of somatization disorder adults had 11.7 times as many emergency room visits as less severely affected somatizers and missed 8.8 times as much school. Parental somatization, substance abuse, and antisocial symptoms predicted children's somatization. Physicians in primary care should be aware of the frequency with which somatization occurs in other members of a family when it is identified in one member.

Adolescent↗

Histogenesis of CD5-positive and CD5-negative B-cell neoplasms on the aspect of somatic mutation of immunoglobulin heavy chain gene variable region.

The immunoglobulin heavy chain (IgH) gene of B-cells dramatically alters twice in their differentiation to memory or plasma cells; VDJ recombination at B-cell precursor and somatic hypermutation, class switch recombination and receptor revision at germinal center (GC) B-cells. Among them, somatic hypermutation of the IgH gene variable region (VH gene) is a powerful tool for detection of B cell differentiation. B-cells and B-cell neoplasms have been divided into following; 1) pre-GC B-cells and neoplasms with a germline VH gene and 2) GC and post-GC B-cells and neoplasms with a somatically mutated VH gene. In this article, we review normal B-cell differentiation and histogenesis of various types of B-cell neoplasms on the aspect of somatic mutation of the rearranged VH gene. In particular, differences between CD5+ and CD5- B-cell neoplasms, using our own data of over 100 cases with B-cell neoplasms, are discussed. Although CD5+ B-cells are included in pre-GC B-cells for the reason of germline VH gene in most of CD5+ B-cells, an about 5% of CD5+ B-cells show somatically mutated VH gene. The rearranged VH gene of CD5+ B-cell neoplasms shows heterogeneity, whereas CD5- B-cell neoplasms possess somatically mutated VH gene with a mean of 8 approximately 12%. Both CD5+ B-cell chronic lymphocytic leukemia and CD5+ diffuse large B-cell lymphoma display that about half of cases show a germline or low frequency of somatic mutation and the others possess somatically mutated VH gene. CD5+ mantle cell lymphoma constitutes most cases with germline and a small number of cases with mutated VH gene. Therefore, CD5- B-cells & CD5- B-cell neoplasms are distinct from CD5+ B-cells and CD5+ B-cell neoplasms in somatic mutation of VH gene. It suggests that each of CD5- and CD5+ B-cells independently has its own differentiation.

B-Lymphocytes↗

Self-reported somatization symptoms associated with risk for extreme alcohol use.

BACKGROUND: The high rates of alcohol use in the population, the increased general health care utilization associated with untreated alcohol problems, and the often diffuse nature of somatization symptoms led us to hypothesize that somatization symptoms might be associated with alcohol use. OBJECTIVE: To determine whether a relationship exists between somatization symptoms and alcohol use. DESIGN: Multivariable logistic regression models were used to analyze existing cross-sectional and 1-year longitudinal survey data from the National Institute of Mental Health Epidemiologic Catchment Area Program. SETTING: Community households. SUBJECTS: Probability sample. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Prevalent and incident heavy or binge drinking ("extreme alcohol use"). These measures are part of the National Institute of Mental Health Epidemiologic Catchment Area Program public core data set that was collected without regard for specific hypotheses. RESULTS: After control for sex, age, and education, 13 self-reported somatization symptoms showed independent cross-sectional associations to prevalent extreme alcohol use. The greater the number of somatization symptoms, the greater the risk, up to a maximum increased odds ratio of 138 to 1, of having comorbid extreme alcohol use when reporting all 13 somatization symptoms in the model. A smaller set of items was associated with the risk for subsequent new onset of extreme alcohol use. CONCLUSIONS: Self-reported somatization symptoms could add to the detection of extreme alcohol use. In addition, primary care and other physicians should consider somatic complaints as possible indicators of concurrent and future risk for extreme alcohol use. Potential benefits of better detection of extreme alcohol use include supporting primary and secondary prevention efforts and reduced expenditures for the diagnostic workup of somatic complaints.

Alcoholism↗

Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity.

CONTEXT: Somatoform disorders are an important determinant of medical care utilization, but their independent effect on utilization is difficult to determine because somatizing patients frequently have psychiatric and medical comorbidity. OBJECTIVES: To assess the extent of the overlap of somatization with other psychiatric disorders; to compare the medical utilization of somatizing and nonsomatizing patients; and to determine the independent contribution of somatization alone to utilization. DESIGN: Patients were surveyed with self-report questionnaires assessing somatization and psychiatric disorder. Medical care utilization was obtained from automated encounter data for the year preceding the index visit. Medical morbidity was indexed with a computerized medical record audit. SETTING: Two hospital-affiliated primary care practices. PARTICIPANTS: Consecutive adults making scheduled visits to their primary care physicians on randomly chosen days. In all, 2668 questionnaires were distributed, and 1914 (71.7%) were returned. Of these, 1546 (80.8%) contained complete data and met eligibility criteria. MAIN OUTCOME MEASURES: Medical care utilization and costs within our hospital system in the preceding 12 months. RESULTS: Two hundred ninety-nine patients (20.5%) received a provisional diagnosis of somatization; 42.3% of these patients had no comorbid depressive or anxiety disorder. Somatizing patients, when compared with nonsomatizing patients, had more primary care visits (mean [SE], 4.90 [0.32] vs 3.43 [0.11]; P<.001); more specialty visits (mean [SE], 8.13 [0.55] vs 4.90 [0.21]; P<.001); more emergency department visits (mean [SE], 1.29 [0.15] vs 0.52 [0.036]; P<.001); more hospital admissions (mean [SE], 0.32 [0.051] vs 0.13 [0.014]; P<.001); higher inpatient costs (mean [SE], USD 3146 [USD 380] vs USD 991 [USD 193]; P<.001); and higher outpatient costs (mean [SE], USD 3208 [USD 180] vs USD 1771 [USD 91]; P<.001). When these results were adjusted for the presence of comorbid anxiety and depressive disorders, major medical morbidity, and sociodemographic characteristics, patients with somatoform disorder still had more primary care visits (P = .04), more specialist visits (P = .002), more emergency department visits (P<.001), more hospital admissions (P<.001), more ambulatory procedures (P<.001), higher inpatient costs (P<.001), and higher outpatient costs (P<.001). When these findings are extrapolated to the national level, an estimated USD 256 billion a year in medical care costs are attributable to the incremental effect of somatization alone. CONCLUSIONS: Patients with somatization had approximately twice the outpatient and inpatient medical care utilization and twice the annual medical care costs of nonsomatizing patients. Adjusting the findings for the presence of psychiatric and medical comorbidity had relatively little effect on this association.

Adult↗

Somatic submodality distribution within the second somatosensory (SII), 7b, retroinsular, postauditory, and granular insular cortical areas of M. fascicularis.

Somatic response properties were determined for over 1,300 neurons isolated within and near the lateral sulci of unanesthetized and unparalyzed cynomolgus monkeys. Somatic stimuli unequivocally activated the majority of units studied in SII (93%) and in cortical fields surrounding SII: area 7b (65%), the retroinsular field (74%), and the granular insula (76%). No activation other than somatic was seen for SII neurons, and noxious somatic stimulation was rarely required. The SII units almost always responded in a rapidly adapting manner to hair or skin stimulation, but not both; however, the submodality distribution seen in SII varied as a function of peripheral receptor locations. Two small zones within SII contained neurons that responded only if the animal actively interacted with the stimulus. In contrast, one-half of the sample of neurons from area 7b unequivocally responded only to somatic stimulation. Although many neurons in the lateral parts of area 7b were vigorously activated by innocuous tactile stimulation, others demonstrated little association with an identifiable somatic submodality, had sluggish responses, required complex, noxious, visual or other non-somatic stimuli for activation, and had labile response properties and receptive fields. Indeed, the responses of some area 7b neurons suggested a possible relationship with the animal's attention towards or anticipation of a noxious or a novel somatic stimulus. Neurons within the retroinsular cortex (Ri), which receives projections from the posterior nucleus (PO), primarily responded to light tactile stimulation of rapidly adapting skin receptors; less than 3% responded to moderate or high threshold mechanical stimulation. The sensitivity to tactile stimulation in Ri closely resembled the responses of SII neurons. Neurons in the granular insula (Ig) often responded to gentle hair deflection within receptive fields covering large areas of the body. Ig and area 7b were the principle loci within the lateral sulcus that contained neurons responding to noxious stimulation. Owing to the great similarity in the somatic response properties within these areas in the awake and unparalyzed animal, the designation of cortical areas could only be made after correlating the recording sites with connectional and cytoarchitectonic analyses in the same animal. Consequently, previous physiological studies may have attributed to SII some of the response characteristics of neurons in neighboring areas.

Animals↗

Somatic mutations in thyroid nodular disease.

Thyroid nodules can be found in up to 50% of inhabitants of iodine-deficient areas and are classified as hot or cold thyroid nodules according to their scintigraphic characteristics. Studies of hot thyroid nodules with comparable mutation detection methods and screening at least exon 10 of the TSH receptor reported frequencies for somatic TSH-receptor mutations ranging from 20 to 82% in patients with similar iodine supply. We have recently screened 75 hot thyroid nodules for somatic TSH-receptor mutations with the more sensitive DGGE method and found somatic TSH-receptor mutations in 57% and Gsalpha mutations in 3%. As 50% of the mutation-negative nodules from female patients are of monoclonal origin when tested for X-chromosome inactivation somatic mutations in other genes are likely to cause the development of hot thyroid nodules. Scintigraphically nonsuppressible areas have been identified in up to 40% of euthyroid goiters in iodine-deficient areas. We recently identified somatic TSH-receptor mutations in microscopic autonomous areas with increased 125T uptake in euthyroid goiters studied by autoradiography 20 years ago. These constitutively activating somatic TSH-receptor mutations in minute autoradiographically hot areas of euthyroid goiters are very likely starting foci which most likely lead to toxic thyroid nodules in iodine-deficient goiters. Therefore iodine deficiency does not only lead to euthyroid goiters but also to thyroid autonomy. The latter is also suggested by epidemiologic studies. Similar mechanisms induced by iodine deficiency and the subsequent hyperplasia, mutagenesis, and selection of cell clones could also lead to cold thyroid nodules by somatic mutations that only initiate growth but not hyperfunction of the affected thyroid epithelial cell. Somatic ras mutations have frequently been detected in histologically characterized thyroid adenomas or adenomatous nodules. However, they seem to be rare in cold thyroid nodules. Since the majority of these latter nodules and 60% of the cold thyroid nodules are monoclonal other somatic mutations are likely in these nodules.

Animals↗

Analysis of the genetic stability of Eucalyptus globulus Labill. somatic embryos by flow cytometry.

Flow cytometry was used to measure the nuclear DNA content of Eucalyptus globulus Labill. somatic and zygotic embryos and leaves in order to determine if somatic embryogenesis induces DNA content and ploidy changes in this species. Mature zygotic embryos derived from open-pollination orchard families were collected from a location in the centre of Portugal. One group was kept for nuclear DNA content and ploidy analysis, and the other group was used for establishing embryogenic cultures. Mature zygotic embryos were grown on Murashige and Skoog (MS) medium supplemented with 3% (w/v) sucrose and 3 mg l(-1) alpha-naphthaleneacetic acid (NAA) for 3 weeks and then transferred to MS medium without growth regulators. Globular somatic embryos from approximately 8-month-old embryogenic cultures were used in the assay. DNA ploidy levels and the nuclear DNA content of mature zygotic embryos, somatic embryos and leaves from the mother field tree were determined using flow cytometry combined with propidium iodide staining. Zygotic embryos had a nuclear DNA content of 1.32 pg/2C, somatic embryos had a nuclear DNA content of 1.39 pg/2C and leaves from the field tree had a nuclear DNA content of 1.40 pg/2C. The values estimated for the somatic embryos and mother plant did not differ statistically from each other (P < or = 0.05), but both differed from those of the zygotic embryos (P < or = 0.05). These results clearly indicate that no changes were induced during the embryogenic process. However, the differences found between the field plants and zygotic embryos did suggest that some aspects must be evaluated carefully, as propidium iodide fluorescence may potentially be influenced by the presence of secondary compounds (e.g. anthocyanins, tannins) in E. globulus somatic embryos and mature leaves. Therefore we believe that the somatic embryogenesis methodology used did not induce major genetic changes in the somatic embryos and that our primary goal of "true-to-type" propagation was assured.

Analysis of Variance↗

Oral health-related quality of life and somatization in the elderly.

OBJECTIVE: Somatization disorders are frequent in the elderly, and previous studies have revealed that psychological factors affect the outcome of measurement of oral health-related quality of life (OHRQoL). The objective of this study was, therefore, to investigate the correlation between OHRQoL and somatization. METHODS: One-hundred and twenty-five participants aged 60 years or older (mean age 76.6 years; 40 males) from a primary geriatric medical hospital participated in this cross-sectional study. OHRQoL was assessed by using the Oral Health Impact Profile (OHIP), somatization by using the somatization subscale of the Symptom Check List (SCL-90-R). To obtain dental data we performed a clinical dental examination. RESULTS: In bivariate analyses the most consistent correlation with somatization was found for overall OHIP sum score and the subscales physical pain and functional limitation (r > 0.4). Participants with high somatization scores had high OHIP sum scores. In multivariate analysis somatization led to additional explanation of the variance of the OHIP sum score and of all OHIP subscales. CONCLUSIONS: There is consistent correlation between OHRQoL and somatization. When evaluating OHRQoL in the elderly (using the OHIP) further evaluation of somatization should be considered for thorough interpretation of the results.

Aged↗

Glutamate decarboxylase immunoreactivity in corticocortical projecting neurons of rat somatic sensory cortex.

Combined retrograde tracing and immunocytochemical experiments were carried out on rats to ascertain whether corticocortical projecting neurons in the somatic sensory areas are immunoreactive to an antiserum against glutamate decarboxylase. Injections of a retrograde tracer (colloidal gold-labelled wheat germ agglutinin conjugated to enzymatically inactive horseradish peroxidase) in the first somatic sensory area labelled neurons in the injected area, in the second somatic sensory area, and in the parietoventral area of the ipsilateral hemisphere. The topographical and laminar distribution of these retrogradely-labelled corticocortical neurons in the first and second somatic sensory areas and in the parietoventral area was in line with a previous description (Fabri M. and Burton H. (1991b) J. comp. Neurol. 311, 405-424). In sections processed for the simultaneous visualization of the retrograde tracer and glutamate decarboxylase immunoreactivity, a number of neurons were double-labelled. Double-labelled neurons were most numerous in the first somatic sensory cortex, where they accounted for 5% of all retrogradely-labelled neurons. Outside this region, double-labelled cells were observed in the second somatic sensory cortex and in the parietoventral cortex, where they amounted respectively to 2.8% and 2.3% of all corticocortical neurons labelled in these two areas. Glutamate decarboxylase-immunopositive corticocortical neurons were mainly concentrated in the infragranular layers (73.8% of all double-labelled neurons in the first somatic sensory area, 81.7% in the second somatic sensory area, and 76.5% in the parietoventral area). The results indicate the presence of a small but significant contingent of GABAergic inhibitory neurons in the associative connections of the somatic sensory areas.

Animals↗

The therapeutic efficacy of somatic acupuncture is not increased by auriculotherapy: a randomised, blind control study in cervical myofascial pain.

Auriculotherapy (ear acupuncture) is a therapeutic technique in which points on the auricle are stimulated with needles. Usually it is combined with somatic acupuncture because of possible synergy, although the efficacy of this pairing has neither been confirmed nor disproved. The aim of this study was to verify: (1) if somatic acupuncture can reduce myofascial cervical pain; (2) if concomitant auriculotherapy improves the efficacy of somatic acupuncture. A group of 62 patients affected by cervical myofascial pain was randomly divided into two groups of 31. Group A (6 males and 25 females) underwent eight sessions of somatic acupuncture. Group B (7 males and 24 females) underwent eight sessions of somatic acupuncture in the same way as group A, paired with auriculotherapy. Pain was scored using the McGill Pain Questionnaire before and at the end of treatment, and 1 and 3 months later. The results showed that both somatic acupuncture and somatic plus ear acupuncture have a positive effect in reducing pain. The pain intensity score was 40.70 +/- 17.78 in group A before therapy and 13.32 +/- 9.62 after therapy; in group B it was 38.90 +/- 15.31 and 13.43 +/- 10.96. Somatic plus auriculotherapy was therefore not statistically significantly superior to somatic therapy alone in the treatment of cervical myofascial pain.

Acupuncture Therapy↗

Psychiatric and somatic comorbidities are negatively associated with quality of life in physically ill patients.

BACKGROUND AND OBJECTIVES: The relationship between somatic and psychiatric comorbidity in patients with somatic diseases and diverse outcome variables like mortality, costs, and duration of treatment is often examined and confirmed. In the last years, quality of life (QoL) as another important outcome variable received more attention. METHODS: The present review comprises a summary of associations between comorbidity and QoL in patients with somatic diseases. For this reason a search for somatic diseases was performed, including metabolic, respiratory tract, musculoskeletal, cardiovascular, cancer, digestive system, and general somatic diseases. Four hundred eighty-one studies were found, of which 45 fulfilled the inclusion criteria. RESULTS: Overall, there are mostly significant negative correlations between comorbidity and QoL. Predominantly, this applies to somatic-psychiatric comorbidity, which accounts for 70.3% (psychosocial aspects of QoL) to 100% (QoL in general) significantly lowered QoL results. Somatic-somatic comorbidities are primarily associated with somatic aspects of QoL (56.5-80.7% significant results), while psychosocial aspects as well as QoL in general are significantly associated in 8.3% to 71.7% of all calculations. CONCLUSION: It is of high relevance for life quality research and clinical practice to pay attention to comorbidity. Methodological shortcomings should be taken into account in future research.

Activities of Daily Living↗

Somatized depression in primary care attenders.

OBJECTIVE: The aim of this study is to determine, within the context of primary care, the frequency of the various ways in which depression is presented with respect to somatic symptoms and to compare depressed patients who present their distress somatically with those with psychological complaints. METHOD: In the two-phase cross-sectional study, first, we screened 906 consecutive patients, and second, we interviewed in detail 306 selected patients. RESULTS: The prevalence of depression was 16.8% (CI 95%: 13.4-20.2). There were 59 cases with psychological presentation, 45 somatizers and 16 had organic disorders with depressive comorbidity. Somatizers had lower level of education, and somatized depression was less serious and caused less repercussion. Detection, antidepressive treatment and psychiatric care were lower for somatizers than for psychologizers. CONCLUSIONS: Somatization is a frequent way to present depression in primary care. For somatizers, depression is less severe and is associated with less repercussion. Somatization is associated with the under-detection of the underlying psychiatric process.

Adolescent↗

Cortical processing of visceral and somatic stimulation: differentiating pain intensity from unpleasantness.

Visceral and somatic pain perception differs in several aspects: poor localization of visceral pain and the ability of visceral pain to be referred to somatic structures. The perception of pain intensity and affect in visceral and somatic pain syndromes is often different, with visceral pain reported as more unpleasant. To determine whether these behavioral differences are due to differences in the central processing of visceral and somatic pain, non-invasive imaging tools are required to examine the neural correlates of visceral and somatic events when the behavior has been isolated and matched for either unpleasantness or pain intensity. In this study we matched the unpleasantness of somatic and visceral sensations and imaged the neural representation of this perception using functional magnetic resonance imaging in 10 healthy right-handed subjects. Each subject received noxious thermal stimuli to the left foot and midline lower back and balloon distension of the rectum while being scanned. Stimuli were matched to the same unpleasantness rating, producing mild-moderate pain intensity for somatic stimuli but an intensity below the pain threshold for the visceral stimuli. Visceral stimuli induced deactivation of the perigenual cingulate bilaterally with a relatively greater activation of the right anterior insula-i.e. regions encoding affect. Somatic pain induced left dorso-lateral pre-frontal cortex and bilateral inferior parietal cortex activation i.e. regions encoding spatial orientation and assessing perceptual valence of the stimulus. We believe that the observed patterns of activation represent the differences in cortical process of interoceptive (visceral) and exteroceptive (somatic) stimuli when matched for unpleasantness.

Adult↗

Seasonal variation of bulk milk somatic cell counts in UK dairy herds: investigations of the summer rise.

Individual cow somatic cell count (SCC) patterns were explored over a one year period in 33 dairy herds to investigate the reason for a summer rise in bulk milk somatic cell counts (BMSCC). Cow test day somatic cell counts were categorised according to the magnitude of change since the previous test day reading, to examine which categories were responsible for the summer increase. Multilevel models using Markov chain Monte Carlo methods were specified to estimate the number of somatic cells/ml produced by different cell count categories. Stage of lactation and parity were accounted for in the models. There was an increase in the proportion of cows that remained above 200,000 cells/ml for two consecutive recordings in summer and this group of cows were responsible for 70.8% of the increase in somatic cells/ml produced from May to September compared with October to March. There was no evidence that a greater new infection rate (somatic cell counts moving from below 100,000 cells/ml to over 200,000 cells/ml) contributed to the increased summer bulk milk somatic cell counts. There was no indication that a general small increase in all somatic cell counts played an important role in the increased summer somatic cell counts. Markov chain Monte Carlo methods provided a valuable and flexible platform for parameter estimation in reasonably complex multilevel models.

Animals↗

Beyond abuse: the association among parenting style, abdominal pain, and somatization in IBS patients.

This study assessed the relative strength of the association between abuse, negative parenting style, and somatization in irritable bowel syndrome (IBS) patients. Drawing from preclinical stress physiology and abuse research identifying the family social climate as a frequently stronger and independent determinant of long-term health effects than abuse-specific variables, we predicted that negative parenting behaviors would more strongly correlate with somatization than abuse. Subjects were 81 consecutively evaluated patients, who at baseline underwent psychological testing, measuring perceived parental style, abuse history, somatization, and pain. Although abuse correlated with maternal and paternal rejection, abuse was not associated with somatization. Higher levels of rejection and/or hostility among fathers (not mothers) were more strongly correlated with somatization than was abuse. Further, paternal parenting behaviors were more predictive of somatization than abuse, age, and gender. The lack of an association between abuse and somatization is discussed in light of limitations of biopsychosocial IBS models, whose strong focus on "pathological stressors" (e.g., abuse, trauma) as risk factors may overlook the importance of "less extreme" parenting variables in influencing somatic complaints. The relationship between parenting and somatization is discussed in the context of broader behavioral science research linking disruptions in the quality of parenting to dramatic and long-term changes in patterns of stress reactivity and brain abnormalities seen in IBS patients.

Abdominal Pain↗

Somatization and somatosensory amplification in psychiatric outpatients: an explorative study.

The aim of the present study was to assess the contribution of somatosensory amplification to somatization. Two questions were addressed: (1) whether somatization is associated with somatosensory amplification independent of level of anxiety or depression, and (2) whether any differences in somatization between patients with panic disorder or depressive disorder and controls can be attributed to differences in somatosensory amplification. The subjects were 673 consecutive psychiatric outpatients. In this sample, 124 patients received a V-code or no psychiatric diagnosis (controls), 82 a single diagnosis of panic disorder, and 68 single diagnosis of major depression. The following measures were used: the Somatosensory Amplification Scale (SSAS), Symptom Checklist-90 (SCL-90), and Hospital Anxiety and Depression Scale (HADS). SCL-90 somatization scores were significantly associated with anxiety scores and to a lesser extent with SSAS scores for somatosensory amplification, independent of gender, presence of physical illness, and depression scores. Moreover, after statistically controlling for differences in somatosensory amplification, panic disorder patients still obtained significantly higher somatization scores than depressive disorder patients, who manifested significantly higher levels of somatization than controls. It is concluded that somatization primarily reflects somatized anxiety and not somatosensory amplification. Somatization associated with panic attacks may result from other mechanisms, such as the psychophysiology of anxiety and cognitive misappraisal of benign bodily symptoms. Further studies into the concurrent validity of the SSAS as a measure of interoceptive acuity are needed.

Adult↗

Perceptions of parents' health status and relationship to somatic preoccupation.

OBJECTIVES: This study was designed to examine the potential relationship of family factors to somatic preoccupation. METHOD: A total of 116 internal medicine patients completed research booklets exploring perceptions of parents' health, childhood trauma, borderline personality symptomatology [Personality Diagnostic Questionnaire-Revised (PDQ-R)], and somatic preoccupation (Bradford Somatic Inventory). RESULTS: Simple correlations revealed that most of the relationships between somatic preoccupation and remaining study variables were statistically significant (e.g., poor parental health status correlated to somatic preoccupation). Using path analysis, poor perception of mother's health demonstrated an indirect effect on somatic preoccupation via borderline personality symptomatology, whereas, poor perception of father's health demonstrated an indirect effect on somatic preoccupation via childhood trauma. Neither parents' health status demonstrated direct effects on somatic preoccupation. CONCLUSIONS: There appear to be parent gender differences in the mediation of the relationship between poor parental health status and somatic preoccupation in the offspring. The implications of these findings are discussed.

Adult↗

Somatization symptoms in the community: a rural/urban comparison.

Somatization is conceptualized as a bodily or somatic expression of psychic distress. Unexplained somatic symptomatology was assessed by use of the National Institute of Mental Health Diagnostic Interview Schedule among community respondents in the Piedmont of North Carolina participating in the Epidemiologic Catchment Area program. Previous literature suggests that somatization is associated with rural residence, less education, lower socioeconomic class, and particular ethnicities. Through use of a multiple regression analysis, lifetime unexplained somatic-symptom counts were regressed on urban residence and other sociodemographic variables. Rural residence was not associated with somatization; rather, somatization was more common among urban residents. The urban/rural differences were greatest among women and high school graduates. Somatization was also associated with being aged 45 to 64, and being separated, widowed, or divorced; it was not associated with race. Overall, somatization was also associated with less education.

Adolescent↗