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
The results of the three articles are discussed and perspectives for further
studies are described.|