6 - Gender, lifespan and cultural aspects

Summary

This chapter demonstrates that a gender perspective can provide valuable insights for better management of bodily distress syndromes and of symptoms in general. Women show more healthcare utilisation, including prescription drugs in response to various health problems, and the female preponderance for 'medically unexplained' symptoms is much higher in clinical than in population studies. Early reports suggested that somatoform disorders were less common in the elderly than in younger age groups and this was attributed either to a decline in neuroticism with age or with difficulties in diagnosis. It has long been recognised that the presentation of bodily symptoms can be profoundly influenced by culture or ethnicity. Culture-bound syndromes mostly originated decades ago from careful clinical descriptions of a limited number of patients made by former generations of cultural psychiatrists and medical anthropologists. It would be expensive to set up specialist services for people of ethnic minorities.