The role of post-migration living difficulties on somatization among first-generation immigrants visited in a primary care service.

The role of post-migration living difficulties (PMLD) on somatization was studied in 101 first generation immigrants visited in primary care. Premigratory traumas and post-traumatic stress disorder (PTSD) were also assessed. About one third of patients somatized. Sociodemographic variables were similar in somatizers and non-somatizers. Premigratory traumas, PTSD and the likelihood to report at least one serious or very serious PMLD were higher in somatizers. Four kinds of PMLD were more frequent in somatizers: worries about unavailability of health assistance, working problems, discrimination and poor social help. Traumas and PTSD influenced the effect of PMLD on somatization. Findings suggest that in specific samples of primary care immigrants severe premigratory traumas increase the sensitivity to PMLD and in turn distress due to PMLD amplifies the tendency to somatize.

[Immigration, trauma, living difficulties and psychopathology: a preliminary study in a primary care setting]. / Immigrazione, traumi, difficoltà vitali e psicopatologia: uno studio preliminare in un setting di medicina generale.

AIM: Investigate the prevalence of Post-Traumatic Stress Disorder (PTSD), anxiety, depression and somatizations in a sample of immigrants visited in a transcultural primary care service. The relationship among psychopathological symptoms, pre-migratory events and post-migration living difficulties is also considered. METHODS: We studied 101 outpatients, attending the "Caritas" Primary Care Unit for immigrants in Rome. All participants fulfilled a socio-demographic questionnaire, a checklist of traumatic events (Harvard Trauma Questionnaire, HTQ), a checklist of post-migration living difficulties (Post-Migration Living Difficulties, PMLD) and the following questionnaires: the HTQ for the assessment of post-traumatic symptoms, the Hopkins Symptom Checklist (HSCL-25) for anxiety and depression, the Bredford Somatic Inventory (BSI) for somatization. RESULTS: 40 patients (39.60%) had an anxiety disorder, 47 (46.13%) a depressive disorder, 16 (15.84%) a PTSD and 39 (38,6%) a somatization syndrome. All these syndromes were significantly correlated. The number of traumatic events and of post-migration difficulties significantly increased the scores on the psychopathological scales. DISCUSSION: The prevalence of psychopathological syndromes in our primary care transcultural unit was high. This not only in refugees, but also in immigrants for other reasons. Moreover, the levels of psychopathological distress were significantly influenced by the number of pre-migratory traumas and of living difficulties in the host country.

The relationship between somatization and posttraumatic symptoms among immigrants receiving primary care services.

Traumatic experiences and somatization are related in studies on complex trauma, though this relation is rarely studied in immigrants. The relationship between somatization and self-reported traumatic experiences and posttraumatic symptoms in patients attending a primary care service for immigrants was studied. The sample consisted of 101 patients attending a primary healthcare service dedicated to immigrants. Participants completed two self-assessment questionnaires specifically designed for use in transcultural research: the Bradford Somatic Inventory and the Harvard Trauma Questionnaire. Both were translated and back-translated into eight languages. Somatization was significantly related to traumatic events and posttraumatic symptoms. In primary care centers for immigrants, physicians should give particular attention to somatization as a possible sign of unreported posttraumatic symptoms.

Somatization in primary care: a comparative survey of immigrants from various ethnic groups in Rome, Italy.

OBJECTIVES: Those responsible for interviewing immigrants in primary care settings often underestimate the importance of somatic symptoms arising from psychological distress. This study investigates the current prevalence of somatization in immigrants, and evaluates the comparative rates of somatic complaints in four ethnic groups (Caucasians, Asians, South/Center Americans, and Africans). METHODS: We studied the 301 consecutive outpatients (aged between 16 and 70 years) attending the "Caritas" primary care unit for immigrants in Rome (Italy) from January to December 2003, all of whom completed the 21-item version of the Bradford Somatic Inventory (BSI-21). Patients scoring 14 or more on the BSI-21 were considered at risk for somatization. RESULTS: The current prevalence of somatization was 35.2%; 62.3% of the somatizers were women. A multiple regression analysis adjusting for the possible confounding effects of sex, age, education, and months of stay in Italy showed that South/Central Americans had significantly higher somatization scores than the other three groups. CONCLUSIONS: These findings suggest a high probability of somatization syndromes in immigrant patients. South/Central Americans tend to somatize more than other ethnic groups. A psychosomatic approach may be useful for immigrants in primary care settings.