Total somatic symptom score as a predictor of health outcome in somatic symptom disorders

Background The diagnosis of somatisation disorder in DSM-IV was based on 'medically unexplained' symptoms, which is unsatisfactory. Aims To determine the value of a total somatic symptom score as a predictor of health status and healthcare use after adjustment for anxiety, depression and general medical illness. Method Data from nine population-based studies (total n=28377) were analysed. Results In all cross-sectional analyses total somatic symptom score was associated with health status and healthcare use after adjustment for confounders. In two prospective studies total somatic symptom score predicted subsequent health status. This association appeared stronger than that for medically unexplained symptoms. Conclusions Total somatic symptom score provides a predictor of health status and healthcare use over and above the effects of anxiety, depression and general medical illnesses. Declaration of interest F.C. has been a member of the American Psychiatric Association DSM-5 work group on somatic distress disorders and he and A.S. are members of the World Health Organization ICD-11 working group on the classification of somatic distress and dissociative disorders.