Somatic symptom disorder in the general population: Associations with medical status and health care utilization using the SSD-12

Objective: 

Somatic Symptom Disorder (SSD) is characterized by excessive thoughts, feelings, and behaviors associated with physical symptoms. DSM-5 criteria for SSD focus on these psychological features (criterion B) rather than the presence or absence of an identifiable medical disorder. This study examines the role of medical disorder in the assessment of SSD and associations of SSD with health care utilization.

Methods: 

Participants (N = 448, mean age 46.7 ± 16.9 years, 53.8% women) were recruited from the general community and completed the SSD-12 to quantify DSM-5 Criterion B for SSD. Participants also provided demographic and medical background information.

Results: 

The SSD-12 total score was elevated in individuals with a major medical disorder (N = 97: cardiovascular disease, cancer, pulmonary disease or other: SSD-12 = 11.6 ± 8.8), and also among those with medical conditions commonly treated in primary care (N = 46: e.g., migraine, asthma: SSD-12 = 8.3 ± 7.1), compared to those free of these disorders (SSD-12 = 5.8 ± 7.0), which remained significant in age- and sex-adjusted models. Normative values are reported. High SSD-12 scores (≥15) were associated with more health care utilization (adjusted OR primary care visits = 3.35, 95%CI = 1.64-6.87).

Conclusions: 

The SSD-12 is a useful tool for the assessment of SSD. Medical comorbidity is associated with higher SSD-12 scores. Future studies are needed to determine whether SSD is more common in medical patients or whether correction of normative values is needed for screening purposes.