Culture sensitivity, health care utilization, and disability in individuals suffering from bodily complaints – a population-based approach
Different bodily complaints are very common in the general population. For many of the most frequent bodily complaints no medical explanation can be found. Consequently they are called medically unexplained or somatoform. Somatoform complaints constitute the core symptoms of somatoform disorders....
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|Summary:||Different bodily complaints are very common in the general population. For many of the most frequent bodily complaints no medical explanation can be found. Consequently they are called medically unexplained or somatoform. Somatoform complaints constitute the core symptoms of somatoform disorders. These are among the most frequent mental disorders in Germany and Europe and are associated with high disability and abnormal illness behavior. In this publication-based cumulus three articles are presented. These base on three areas which are of major importance for investigations about bodily complaints or somatoform disorders. These areas are the following: 1. Culture sensitivity, 2. Health care utilization, and 3. Disability. Ad 1. The perception and presentation of bodily complaints, as well as the most frequent bodily symptoms are influenced by the cultural background. Persons with another cultural background (i. e. migrants) share approximately 19% of the German population. However, their mental health has only rarely been investigated. In the first article in this cumulus it is analysed to what extent two common questionnaires for the assessment of somatoform disorders and depression measure the same in Germans as in migrants in Germany (i. e. measurement invariance). Measurement invariance is a crucial precondition for the interpretation of studies on migrants. It was fulfilled for both questionnaires. Ad 2. Somatoform disorders are related to high health care utilization. The influence of psychological factors on health care utilization has rarely been investigated so far. Also, most studies investigating health care utilization studied selected samples. In the second article in this cumulus predictors for health care utilization are analysed. A representative sample of the German general population as well as a sub-group of persons with many somatoform complaints and a sub-group of persons with few somatoform complaints are investigated. Beside other predictors the intention to visit a doctor in the hypothetical situation of having different bodily complaints was analysed. In all three groups the same predictors for health care utilization were found. Beside the number and severity of bodily complaints, the mental health, and the employment status, the intention to visit a doctor was an important predictor. Ad 3. The disability by complaints is one of the most important criteria in diagnosing mental disorders. Thereby, disability is defined as any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human. However, it has not been investigated what the range of normal disability by bodily symptoms is. In the third article in this cumulus a questionnaire for the assessment of disability by bodily symptoms is evaluated in a representative sample of the German general population. Also, normative data for people with at least one bodily complaint are presented and the influence of disability on health care utilization is investigated. The normative data can be used to describe clinical samples. The results of the three articles are discussed and perspectives for further studies are described.|