Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-27T21:35:47.028Z Has data issue: false hasContentIssue false
  • English
  • Français

The South London Somatisation Study

I: Longitudinal Course and the Influence of Early Life Experiences

Published online by Cambridge University Press:  02 January 2018

T. K. J. Craig ,
A. P. Boardman ,
K. Mills ,
O. Daly-Jones  and
H. Drake
T. K. J. Craig*
Affiliation:
St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH
A. P. Boardman
Affiliation:
Department of Psychiatry, Keele University, Thornburrow Drive, Hartshill, Stoke-on-Trent ST4 7QB
K. Mills
Affiliation:
Research & Development for Psychiatry, 134–138 Borough High Street, London SE1 1LB
O. Daly-Jones
Affiliation:
Research & Development for Psychiatry, 134–138 Borough High Street, London SE1 1LB
H. Drake
Affiliation:
Research & Development for Psychiatry, 134–138 Borough High Street, London SE1 1LB
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

In a two-year longitudinal study, a two-stage screening procedure was used to identify subjects in primary care with emotional disorder presenting with a recent onset of physical symptoms and a comparison sample of patients presenting with physical symptoms only. Somatisers (n = 44) were defined as subjects who had an emotional disorder but who presented with physical symptoms that could not be attributed to organic disease. The course and outcome of these conditions were compared with those of pure emotional disorder (n = 11), pure physical disorder (n = 90) and ‘mixed’ conditions (n = 39). The physical symptoms of somatisers were less likely to improve and lagged behind those of the other groups, and 16 of these acute somatisers went on to develop chronic somatoform disorders. Among somatisers, changes in physical symptom levels throughout the follow-up closely mirrored changes in emotional arousal. Emotionally disordered subjects reported more instances of parental lack of care, but somatisers were also more likely than other groups to report parental physical illness and to have had more physical illness themselves in childhood. A logistic regression suggests that adult somatisation is best modelled by parental lack of care followed by childhood illness.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 163 , Issue 5 , November 1993 , pp. 579 - 588
Copyright
Copyright © Royal College of Psychiatrists, 1993 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: American Psychiatric Association.Google Scholar
Andersen, R., Francis, A., Lion, J., et al (1977) Psychologically related illness and health services utilisation. Medical Care, 15, 59–73.Google Scholar
Apley, J. & Hale, B. (1973) Children with recurrent abdominal pain: How do they grow up? British Medical Journal, iii, 7–9.CrossRefGoogle Scholar
Barsky, A. J., Wyshak, G. & Klerman, G. I. (1986) Medical and psychiatric determinants of outpatient medical utilization. Medical Care, 24, 548–563.CrossRefGoogle ScholarPubMed
Bifulco, A. (1985) Death of Mother in Childhood and Clinical Depression in Adult Life: A Biographical Approach to Aetiology. PhD Thesis, University of London.Google Scholar
Bifulco, A., Brown, G. W. & Harris, T. O. (1987) Childhood loss of parent, lack of adequate parental care and adult depression: a replication. Journal of Affective Disorders, 12, 115–128.Google Scholar
Boardman, A. P. (1987) The General Health Questionnaire and the detection of emotional disorder by general practitioners. British Journal of Psychiatry, 151, 373–381.Google Scholar
Bridges, K. W. & Goldberg, D. P. (1985) Somatic presentations of DSM-III psychiatric disorders in primary care. Journal of Psychosomatic Research, 29, 563–569.Google Scholar
Bridges, K. W., Goldberg, D. P., Evans, B., et al (1991) Determinants of somatization in primary care. Psychological Medicine, 21, 473–484.Google Scholar
Brown, G. W. (1988) Early loss of parent and depression in adult life. In Handbook of Life Stress, Cognition and Health (eds Fisher, S. & Reason, J.). London: Wiley.Google Scholar
Brown, G. W. & Harris, T. O. (1978) The Social Origins of Depression. London: Tavistock Press.Google Scholar
Brown, G. W., Craig, T. K. J. & Harris, T. (1985) Depression: disease or distress? Some epidemiological considerations. British Journal of Psychiatry, 147, 612–622.CrossRefGoogle ScholarPubMed
Craig, T. K. J. & Brown, G. W. (1985) Goal frustration and life events in the aetiology of painful gastrointestinal disorder. Journal of Psychosomatic Research, 28, 411–421.CrossRefGoogle Scholar
Craig, T. K. J., Brown, G. W. & Harris, T. O. (1987) Depression in the general population: comparability of survey results. British Journal of Psychiatry, 150, 707–708.Google Scholar
Dean, C., Surtees, P. G. & Sashidharan, S. P. (1985) Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry, 142, 247–256.Google Scholar
Deighton, C. M. & Nicol, A. R. (1985) Abnormal illness behaviour in young women in a primary care setting: Is Briquet's syndrome a useful category? Psychological Medicine, 15, 515–520.Google Scholar
Escobar, J. L., Burnan, M. A., Karno, M., et al (1987) Somatisation in the community. Archives of General Psychiatry, 44, 713–718.Google Scholar
Finlay-Jones, R. A., Brown, G. W., Duncan-Jones, P., et al (1980) Depression and anxiety in the community. Psychological Medicine, 10, 445–454.Google Scholar
Goldberg, D. P. & Blackwell, B. (1970) Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal, ii, 439–443.Google Scholar
Goldberg, D. P. & Bridges, K. (1987) Screening for psychiatric illness in general practice: the general practitioner versus the screening questionnaire. Journal of the Royal College of General Practitioners, 37, 15–18.Google Scholar
Goldberg, D. P. & Bridges, K. (1988) Somatic presentations of psychiatric illness in primary care setting. Journal of Psychosomatic Research, 32, 137–144.CrossRefGoogle ScholarPubMed
Goldberg, D. P. & Hillier, V. (1979) A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.Google Scholar
Harris, T., Brown, G. W. & Bifulco, A. (1986) Loss of parent in childhood and adult psychiatric disorder: the role of parental care. Psychological Medicine, 16, 641–659.Google Scholar
HartviG, P. & Sterner, G. (1985) Childhood psychologic environmental exposure in women with diagnosed somatoform disorders. Scandinavian Journal of Social Medicine, 13, 153–157.Google Scholar
Katon, W., Kleinman, A. & Rosen, G. (1982) Depression and somatisation: A review. American Journal of Medicine, 72, 127–135.Google Scholar
Kellner, R. (1966) Neurotic symptoms in women: Attendances in a general practice. British Journal of Psychiatry, 112, 75–77.Google Scholar
Kriechman, A. M. (1987) Siblings with somatoform disorders in childhood and adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 226–231.Google Scholar
Mann, A. H., Jenkins, R. & Belsey, E. (1981) The twelve-month outcome of patients with neurotic illness in general practice. Psychological Medicine, 11, 535–550.Google Scholar
McFarland, B. H., Freeborn, D. K., Mullooly, J. P., et al (1985) Utilization patterns among longterm enrollees in a prepaid group practice health maintenance organization. Medical Care, 23, 1211–1233.CrossRefGoogle Scholar
Mechanic, D. (1964) The influence of mothers on their children's health attitudes and behaviour. Pediatrics, 33, 444–453.Google Scholar
Mechanic, D. (1979) Development of psychological distress among young adults. Archives of General Psychiatry, 36, 1233–1239.Google Scholar
Menninger, W. C. (1947) Psychosomatic medicine: somatization reactions. Psychosomatic Medicine, 9, 92–97.Google Scholar
Murphy, E. & Brown, G. W. (1980) Life events, psychiatric disturbance and physical illness. British Journal of Psychiatry, 136, 326–338.Google Scholar
Shapiro, E. G. & Rosenfeld, A. A. (1986) The Somatizing Child. New York: Springer-Verlag.Google Scholar
Williams, P., Tarnopolsky, A., Hand, D., et al (1986) Minor psychiatric morbidity and general practice consultations: the West London Survey. Psychological Medicine Monograph (Suppl. 9).Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms: an Instruction Manual for the Present State Examination and CA TEGO Programme. Cambridge: Cambridge University Press.Google Scholar
Wright, A. F. & Perini, A. F. (1987) Hidden psychiatric illness: use of the general health questionnaire in general practice. Journal of the Royal College of General Practitioners, 297, 164–167.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.