Somatization in women and men with non-cardiac chest pain compared to the general Swedish population

Abstract

We compare the prevalence of somatization in women and men with NCCP in relation to the general Swedish population, analyze the overlap between somatization, cardiac anxiety, and depressive symptoms, and explore variables associated with somatization. A cross sectional design is implemented with data collected between late October 2013 and early January 2014 from 552 patients with NCCP (mean age of 64 ​± ​17 years, 51% women) from four hospitals in southeast Sweden. Somatization was measured with the Patient Health Questionnaire-15, cardiac anxiety with the Cardiac Anxiety Questionnaire, and depressive symptoms with the Patient Health Questionnaire-9. Data were self-reported. The general population consists of 1898 females and 1508 males. Compared to the general population, somatization was significantly ( p ​< ​.001) more common in both women and men with NCCP. Women with NCCP had significantly ( p ​= ​.003) higher prevalence of somatization than men with NCCP. In patients with NCCP, 12% had only somatization, whereas 39% also reported cardiac anxiety and depressive symptoms. Younger age in women tended to be associated with somatization (OR ​= ​0.98, p ​< ​.073), but also being non-worker (OR ​= ​0.40, p ​= ​.024). In men, somatization tended to be associated with increased healthcare contacts (OR ​= ​1.82, p ​= ​.051). Furthermore, in both women and men, number of co-morbidities (OR ​= ​9.69 p ​< ​.001 and OR ​= ​3.45, p ​= ​.002), cardiac anxiety (OR ​= ​2.93 and OR ​= ​2.09, p ​< ​.001), and depressive symptoms (OR ​= ​8.71 and OR ​= ​4.44, p ​< ​.001) were significantly associated with somatization. Our study demonstrates that somatization is very common among patients with NCCP, especially in women. Patients with NCCP have higher somatization and greater overlap with psychological distress compared to the general population. • Somatization is more common in women and men with NCCP compared to the general population. • Somatization often overlaps with cardiac anxiety and depressive symptoms. • Somatization is associated with increased healthcare use and co-morbidity.