Psychosomatic Health Problems Research Articles

Influencing factors on the psychosomatic health of medical staff since the normalized stage of COVID-19 in mainland China.

During the coronavirus disease 2019 (COVID-19)pandemic, there were under-recognized and unaddressed psychosomatic health problems among medical staff. The purpose of this study was to investigate their psychosomatic status. An online questionnaire was performed to the medical staff of major hospitals in Jinan in January 2023. In total, 1244 valid questionnaires were collected, and their psychosomatic status was assessed by the Psychosomatic Symptom Scale (PSSS) and Perceived Stress Scale-10 (PSS-10). Finally, we analyzed the influencing factors for their psychosomatic status. The psychological health of the medical staff was poor, and the level of stress perception was intense, accompanied by obvious psychosomatic symptoms. Regression analysis indicated that age, gender, frontline involvement, work experience, marriage, presence of disease history and COVID-19 infection history were risk factors for psychosomatic symptoms, while education, frontline involvement and presence of disease history were risk factors for stress feeling. Medical staff often showed obvious psychosomatic symptoms and intense stress. Psychological health education and intervention should be given in order to improve their working quality.

Cyber-victimization and Its Impact on Victim’s Psychosomatic Status

Cyberbullying is an important issue to discuss and investigate. This study is a theoretical and empirical research aimed at proving cyber-victimization’s negative impact on psychosomatic health. A direct relationship between these two phenomena is that poor mood regulation in childhood entails dissatisfaction with surrounding world causing rage against weaker peers, victimization, which affects victims’ psychosomatic status. Methods used are literature analysis for the research and empirical part assessing aggressiveness in children (Buss-Darkey Inventory), their emotional state and psychosomatic health problems caused by victimization (authors’ questionnaire. As a result young victims’ psychosocial problems are seen as having negative consequences in later life. Because of these consequences, bullying becomes a hot topic and causes researchers, parents’, as well as school teachers and school psychologists’ concern. Cyberbullying will continue as long as electronic gadgets and communication devices are plugged in and used which is becoming an increasing problem due to dissemination of information, telecommunication technologies and the involvement of children and adolescents in the widespread digitalization of various spheres of life. In conclusion we recommend teachers and parents to develop understanding of cybervictimization, besides to pay attention to their children’s emotional intelligence development that should help them resist victimization and avoid health problems.

COVID-19 and unfavorable changes in mental health unrelated to changes in physical activity, sedentary time, and health behaviors among Swedish adolescents: A longitudinal study.

The COVID-19 pandemic has had major impact on the daily lives of adolescents. This study examined whether mental health outcomes had changed over the pandemic, and if such changes were related to changes in physical activity (PA), sedentary time, sleep, screen time, and participation in organized sports. In this longitudinal study, data were collected in autumn 2019 with follow-up measurements in spring 2021. In total, 558 schools were invited and 34 schools around Stockholm with a variation in socioeconomic background were included. Physical activity and sedentary time were measured for seven consecutive days by accelerometry (Actigraph). Anxiety, health-related quality of life (HRQoL), psychosomatic health, stress, sleep duration, screen time, and organized sports participation were self-reported in questionnaires. Linear models were applied to estimate associations between changes in mental health outcomes and exposures. From the baseline sample of 1,139 participants, 585 (55% girls), mean (SD) age 14.9 (0.3) years, participated in the follow-up. Between 2019 and 2021, there was a decrease in HRQoL [mean difference -1.7 (-2.3, -1.2), p < 0.001], increase in psychosomatic health problems [mean difference 1.8 (1.3, 2.3), p < 0.001], and an increase in the number of participants with high stress [from 94 (28%) to 139 (42%), p < 0.001]. Weekly light PA and sleep duration decreased and weekly sedentary time and screen time increased unrelated to changes in mental health outcomes. An increase in sleep duration during weekdays was significantly related to both a decrease in anxiety (B = -0.71, CI: -1.36, -0.06) and an increase in HRQoL (B = 1.00, CI: 0.51, 1.49). During the COVID-19 pandemic, mental health appears to have been impaired in Swedish adolescents, but unrelated to changes in PA, sedentary time, screen time, or participation in organized sports. However, increased sleep duration on weekdays was related to less anxiety and better HRQoL. The results may help policy makers and other stakeholders comprehend the differential effects of the COVID-19 pandemic on mental health outcomes and help guiding the planning of policy actions. ISRCTN15689873.

The Influence of COVID-19 and Psychosocial Risks on Burnout and Psychosomatic Health Problems in Non-University Teachers in Spain during the Peak of the Pandemic Regressions vs. fsQCA

During the COVID-19 pandemic, teachers had to adapt to the changes caused by remote working, experiencing prolonged stress situations that together with psychosocial factors can lead to burnout and psychosomatic health problems. This study focused on analyzing the influence of COVID-19 and psychosocial risks on psychosomatic problems and burnout at the peak of the pandemic in Spain, from March to April 2020. It combined two methodologies, hierarchical regression models (HRM) and qualitative comparative analysis (QCA). The two methodologies demonstrated greater predictive power for psychosocial demand factors (workload and role conflict) on burnout and psychosomatic health problems. In addition, the fsQCA models demonstrated the contribution of job insecurity and the lack of organizational justice, resources and COVID-19 information. These results can be used by educational managers to improve the daily work of teachers, impacting on the quality of teaching, as well as their response to pandemics, which will benefit society.

Internet use and cyberbullying: Impacts on psychosocial and psychosomatic wellbeing among Chinese adolescents

The use of the internet for entertainment has increased hugely over the last decade among Chinese adolescents, but the psychosocial impacts remain unclear. The aims of this study are to explore the associations between internet use, cyberbullying and psychosocial wellbeing among Chinese adolescents. Questionnaires were completed in the classroom setting by 3378 middle school students aged 11–16 years old (M = 13.58, SD = 0.87) in three provinces representing eastern, central and western China. Key findings included: 1) Internet use of over 3 h per day was associated with higher prevalence of anxiety [OR = 1.6, 95% CI (1.1, 2.2), p = 0.006], depression [OR = 2.1, 95% CI (1.7, 2.6), p < 0.001] and psychosomatic health problems, such as abdominal pain [OR = 2.4, 95% CI (1.8, 3.3), p < 0.001]. 2) Boys were much more likely to play online games. 3) Moderate time of gaming was overall beneficial to well-being. 4) Cyberbullying was common, with 37.5% admitting involvement. 5) Bully-victims were most vulnerable to mental and psychosomatic health problems, and only-bullies were the least vulnerable group. Our findings suggest moderate internet use for entertainment is not detrimental to mental health, but excessive use is. Schools should promote adolescents’ responsible use of the internet and incorporate anti-cyberbullying programs into the curriculum.

Attentional processing of unpleasant stimuli in alexithymia: Early avoidance followed by attention maintenance bias

Alexithymia is a multifaceted personality trait linked to increased risk for psychological, psychosomatic, and physical health problems. One hypothesized mechanism through which alexithymia predisposes individuals to such problems is the interference of alexithymic characteristics in processing affective, particularly unpleasant content. This study aimed to investigate the relationship between alexithymia and biases in attentional processing of threatening vs. neutral pictorial stimuli, disentangling early (vigilance) from late (maintenance) attentional biases. One hundred participants (77 female; 18–35 years old) completed the Toronto Alexithymia Scale and underwent a free viewing task with picture pairs presenting illness, fear and neutral content, during which dwell time on each picture was recorded at time intervals of 0–500 ms, 501–1000 ms and 1001–6500 ms of exposure. Results from multilevel modeling showed that alexithymia interacted with time interval and picture type. Higher alexithymia scores were related to less dwell time towards fear pictures at 501 ms-1000 ms, but more dwell time at 1001 ms-6500 ms after stimulus onset. This effect was particularly observed for the externally oriented thinking and the difficulty in describing feelings facets of alexithymia, but not the difficulty in identifying feelings. There was no effect of alexithymia on early vigilance at 0–500 ms. This study provides evidence on the association between alexithymic traits and early avoidance, along with late maintenance bias to fear, which appears consistent with the view that alexithymia is associated with avoidant emotion regulation processes, but also greater requirements of cognitive resources for processing affective information.

The Associations Between Problematic Internet Use, Healthy Lifestyle Behaviors and Health Complaints in Adolescents

This study aimed to explore relationship between problematic internet use (PIU), healthy lifestyle behaviors and subjective health complaints.Methods: Participants (396 adolescents, aged 11–18 years) from 34 general education schools across Latvia completed online survey. The PIU was assessed by the Problematic and Risky Internet Use Screening Scale (PRIUSS) collecting data on social impairment, emotional impairment, and risky/impulsive internet use. The subjective health complaints assessed were somatic and psychological symptoms. Healthy lifestyle behaviors assessed were daily physical activities, time spent in using information technologies (IT), eating habits, and duration of sleep.Results: This study found that 31.00% (n = 124) of the participants scored at risk for PIU. Correlates associated with PIU were subjective health complaints, low physical activity, lack of meals together with family and disturbed sleeping regimes on weekends (P &amp;lt; 0.001). Stepwise multiple regression analyses showed that 34% of the variance in the PRIUSS scores was explained by psychological health complaints (irritability, depression, and nervousness), screen time use on weekends, physical activity, drinking sweetened soft drinks and unhealthy eating habits.Conclusion: PIU behaviors among adolescents in Latvia are associated with psychological symptoms and unhealthy lifestyle. Further effective measures and interventions are needed to prevent development of psychosomatic health problems.

Student achievement goals and psychosomatic health complaints among Swedish adolescents: the role of sex

AimSchool related determinants (e.g. student motivation and goals) may be important for student achievement as well as their mental health. Therefore, the aim of this study was to analyse the links between two goal orientations (mastery and performance) and psychosomatic health problems by investigating the general patterns as well as the patterns for specific classifications of students, in particular by investigating the potential statistical interaction effects by gender.Subject and methodsSwedish nationally representative data among 4573 school year 9 students (15–16 years old) responding to the Evaluation Through Follow-up (ETF) questionnaire, in 2014, were used. Linear regression analysis as well as multinomial logistic regression were applied in order to address the research questions.ResultsBoth the mastery orientation and the performance orientation are independently associated with adolescent psychosomatic health problems. The links between these goal orientations and psychosomatic health show different patterns. The mastery goal orientation may be considered a protective factor as there is a negative link to psychosomatic problems; the performance orientation may be considered a risk factor due to the positive association with psychosomatic health problems. The effect of performance orientation on psychosomatic health complaints was significantly stronger for girls (OR = 4.28) compared to boys (OR = 2.04). In particular, low mastery/high performance students may be at risk for experiencing poor psychosomatic health.ConclusionAdolescent psychosomatic health may be improved by the encouragement of student goals related to adaptive and successful goal profiles such as mastery orientation.

Patient-physician communication about financial problems: A cross-sectional study among over-indebted individuals

About every tenth household across Europe is unable to meet payment obligations and living expenses on an ongoing basis and is thus considered over-indebted. Previous research suggests that over-indebtedness reflects a potential cause and consequence of psychosomatic health problems and limited access to care. However, it is unclear whether those affected discuss their financial problems with general practitioners. Therefore, this study examined patient-physician communication about financial problems in general practice among over-indebted individuals. We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017. We assessed the prevalence of patient-physician communication about financial problems and its association with patient characteristics using descriptive statistics and logistic regression analysis. Of 699 individuals who returned the questionnaire (response rate:50.2%), we included 598 respondents enrolled in statutory health insurance with complete outcome data in the analyses. Conversations about financial problems with general practitioners were reported by 22.6% (n = 135) of respondents. Individuals with a high educational level were less likely to report such conversations than those with medium educational level (aOR 0.11; 95%CI 0.01-0.83) after adjustment for other sociodemographic characteristics, health status and measures of financial distress. Those without a migrant background(aOR 2.09; 95%CI 1.32-3.32), the chronically ill(aOR 1.90; 95%CI 1.16-3.13) and individuals who reported high financial distress(aOR 2.15; 95%CI 1.22-3.78) and cutting on necessities to pay for medications(aOR 1.86; 95%CI 1.12-3.09) were more likely to discuss financial problems than their counterparts. Few over-indebted individuals discussed financial problems with their general practitioner. Patients' health status, coping strategies and perception of financial distress might contribute to variations in disclosure of financial problems. Thus, enhancing communication and screening by routine assessment of financial problems in clinical practice can help to identify vulnerable patients and promote access to health care and social services and well-being for all.

Association of screen time with subjective health complaints in Iranian school-aged children and adolescents: the CASPIAN-V study

Sedentary leisure time might be affecting children’s and adolescents’ general health. We investigated the association between watching television and computer use in this age group and psychosomatic health complaints. This study of 14,274 students aged 7–18 years was conducted in Iran between 2014 and 2015, as part of the fifth school-based nationwide health survey named the childhood and adolescence surveillance and prevention of adult non-communicable disease (CASPIAN-V) study. In addition to gathering data on time spent watching television or using a computer per day, we categorized the health complaints into somatic (headache, backache, stomach ache, and feeling dizzy) and psychological (feeling low, feeling nervous, irritability, and difficulty falling asleep) symptoms. Regression models were used to determine the relationships between variables. All psychological health complaints, as well as headaches, were significantly more prevalent in the over-14 age group, both in girls and boys. Lower socioeconomic status, living in families where one or two parents were absent, and living in urban areas were all associated with higher psychosomatic health problems. Also, more time spent watching television was associated with more stomach aches and irritability (OR = 1.12 and 1.14 respectively). More time spent using a computer correlated with a higher prevalence of stomach aches, irritability, feeling nervous, and difficulty falling asleep (OR = 1.15, 1.12, 1.29, and 1.07 respectively). Prolonged time spent on television watching or computer use might be associated with adverse effects on children’s and adolescents’ psychosomatic health status.

Medico-social challenges of ex-serviceman and their spouse: a cross-sectional study in Punjab

Background: Due to arduous and hazardous nature of their duties in varied inhospitable terrain Ex-army servicemen are more prone to various psycho-somatic and chronic health problems, and they need assistance for resettlement, rehabilitation and adjustment in civil stream. Objectives: To study social and health problems of ex-army servicemen and their spouse. Materials and Methods: Descriptive cross-sectional study conducted in the month of May 2013, in mega health camp for Ex-army servicemen of two days organized by army in collaboration with Govt. Medical College Patiala. Total of 202 ex-army servicemen and their spouse were interviewed using pre-structured and pretested Proforma. Findings were statistically analyzed using percentages and p-value. Results: 202 participants, male (44.5%) and female (55.5%), with mean age 66.5+ 6.2, almost 40% were illiterate. Male have significantly higher literacy. Almost 50% of the subjects have monthly income between 6,000-10,000Rs and very few were self-employed or reemployed. Three or more morbidities in 54.5% subjects and this association with age was statistically significant. The most common morbidities were hypertension/cardiovascular diseases (77.2%), and musculoskeletal (54.4%). 91.5% were on treatment and compliance to treatment was 80%. Around 33% subjects were feeling sad, mostly because of neglect (12%), poverty (6.4%) and loneliness (4%). Conclusion: Majority of Ex-army servicemen and their spouses were having multiple co-morbidities. Most of them were not involved in any productive job and have low income. Periodic screening of this high risk group and policy formulations at Govt level for their engagement in productive work is need of hour.

Does the Strength of the Association Between Peer Victimization and Psychosomatic Health Problems Depend on Whether Bullying or Peer Aggression is Measured?

This study aimed to analyze to what extent the strength of the previously established association between peer victimization and psychosomatic problems depends on which of two measures is being used, a measure of bullying and a measure of peer aggression. The study included 2568 Swedish adolescents aged 13–15 years. An Ordinary Least Square regression showed that all regressors representing bullying and peer aggression revealed significant effects on psychosomatic health using no peer victimization as the reference category. An ANOVA showed no significant differences in mean values on the Psychosomatic Problems Scale captured by the two measures. Given that both measures of peer victimization show strong associations with psychosomatic health, using only one of the two measures is therefore likely not just to underestimate the overall prevalence of peer victimization but also the number of children experiencing psychosomatic problems in relation with peer victimization.

Job satisfaction, job stress and psychosomatic health problems in software professionals in India.

This questionnaire based study investigates correlation between job satisfaction, job stress and psychosomatic health in Indian software professionals. Also, examines how yoga practicing Indian software professionals cope up with stress and psychosomatic health problems. The sample consisted of yoga practicing and non-yoga practicing Indian software professionals working in India. The findings of this study have shown that there is significant correlation among job satisfaction, job stress and health. In Yoga practitioners job satisfaction is not significantly related to Psychosomatic health whereas in non-yoga group Psychosomatic Health symptoms showed significant relationship with Job satisfaction.

The Pursuit of Happiness, Stress and Temporomandibular Disorders

Mismanaging the pursuit of happiness causes negative psychological effects such as stress and disappointment. The resultant stress often manifests itself as psychological and physical health problems. We explore the problems of measuring happiness according to materialistic wealth and demonstrate that misinterpreting happiness can lead to a stress inducing pursuit. The happiness that human beings pursue is often material-based hedonism whereas eudaimonic happiness has been shown to be a by-product of the pursuit of meaningful activities. Pursuing a predefined happiness, the failure to achieve it and the resistance to it can create stress induced psychosomatic health problems; temporomandibular disorders (TMD) are one such example. Masticatory myofascial pain syndrome is a form of TMD that has a strong association to psychological stress. In this paper the research on TMD associated facial pain across different socioeconomic status (SES) groups is utilized to compare an objective, stress related physiological disorder with happiness data. We also discuss how the pressures of pursuing socially determined aesthetic happiness such as conforming to society’s expectations of smile and facial aesthetics can drive people to make surgical or orthodontic changes. This review proposes that pursuing happiness has the propensity to cause not only psychological stress but also negative behaviors. We aim to encourage further scientific research that will help to clarify this philosophical pursuit.

PSYCHOSOMATIC PROBLEMS AS THE RESULTS OF PARTICIPATION IN BULLYING BEHAVIOUR OR RISK FACTOR FOR INVOLVEMENT IN BULLYING BEHAVIOR

Objective – To find out whether involvement in bullying behaviour precedes psychosomatic symptoms or whether these symptoms precede involvement in bullying behaviour. Subjects and methods – A six-month longitudinal study with baseline measurements taken in the autumn of 2008 and follow-up measurements in the spring of 2009 in four elementary schools in the Siroki Brijeg municipalities. The study included 536 children aged 11 to 15 years, who participated by filling out a questionnaire on both occasions of data collection. A self-administered questionnaire measured peer violence and a wide variety of psychosomatic symptoms. Results – Children involved in bullying behaviour at the beginning of the school year compared to children who were not involved in bullying behaviour had significantly higher chances of developing psychosomatic symptoms such as nervousness and tension (OR=2.59; p=0.010), feeling tired for no reason (OR=2.0; p=0.008) and a feeling of energy loss (OR=2.18; p=0.050) during the school year. At the same time, some psychosomatic problems increase the likelihood of involvement in bullying behaviour. Children who were identified at the beginning of the school year as neutral and who had psychosomatic symptoms which had manifested as dizziness (OR=0.97, p=0.019), feeling tired for no reason (OR=1.84, p=0.018), pain (OR=2.45, p=0.001), eye problems (OR=1.94, p=0.047) and a feeling of energy loss (OR=2.06, p=0.045) were at greater risk of participation in peer violence during the school year. Conclusion – Many psychosomatic health problems follow involvement in bullying behaviour. Furthermore, our results indicate that children with some psychosomatic health symptoms are at increased risk of being involved in bullying behaviour.

The Impact of Bullying and Victimization on Students' Relationships

Background: Bullying is antisocial behavior, in which people are willfully and repeatedly hurt. Bullies are perpetrators of this behavior, victims are those who are bullied, and bully/victims are students who both bully others, and are bullied themselves. Bullies, victims, and bully/victims are at risk for psychosomatic health problems. However, few studies have focused on their social health. Purpose: This study explores differences between non-involved students, bullies, victims and bully/victims in self-reported attachment to peers and parents, perceived support from teachers, and belonging to the school, in Flemish secondary schools. Methods: We use data from the Flemish Educational Assessment (FlEA), consisting of 11,872 students in 85 schools. Multivariate analyses of variance (ANOVA) were performed. Results: Non-involved students felt most attached to peers, parents, teachers, and school. Bullies matched the level of parental attachment of the non-involved, and are even more popular among peers. Victims are especially unsuccessful among peers. Bully/victims felt least attached to peers, parents and school, and least supported by teachers. Discussion: Bullies appear to be popular among peers. Victims and bully/victims lack a number of important sources of support. Translation to Health Education Practice: The results of this study endorse peer-group level intervention initiatives. Furthermore, we support whole-school approaches that include all actors-including pupils, parents, and teachers-in combating bullying.

Does the association with psychosomatic health problems differ between cyberbullying and traditional bullying?

The association between mental health problems and traditional bullying is well known, whereas the strength of the association in cyberbullying is less known. This study aimed to compare the association between mutually exclusive groups of bullying involvement and psychosomatic problems as measured by the PsychoSomatic Problems scale. The sample comprised 3820 students (13–16 years old) in Sweden. The results indicate an association between bullying and psychosomatic problems, regardless of type of bullying involvement. No statistically significant differences in psychosomatic problems were found between cyberbullying and traditional bullying, either for victims or for bullies. The results do not confirm the hypothesis that the association between bullying and mental health is stronger for cyberbullying than for traditional bullying. Another important finding is that cyberbullies seem as likely as cybervictims to be at risk for mental health problems.

Working life and stress symptoms among caregivers in elderly care with formal and no formal competence

The aim of the present study was to describe and compare caregivers with formal and no formal competence on job satisfaction, psychosomatic health, structural and psychological empowerment and perceptions of care quality. A further aim was to study relationships among study variables. A convenience sample of 572 caregivers in elderly care participated. Caregivers with no formal competence perceived higher workload, more communication obstacles, less competence, poorer sleep and more stress symptoms than did their colleagues. Linear regression analyses revealed that the factor self-determination was an explanatory variable of stress levels among caregivers with no formal competence, and self-determination and impact among caregivers with formal competence. Linear regression analysis revealed that different dimensions in structural and psychological empowerment explained the variance in staff job satisfaction, perceived stress symptoms and quality of care. No formal competence seems to be a risk factor for psychosomatic health problems. Managers need to have a strategic plan for how to create a working environment for caregivers with no formal competence. Caregivers' self-determination seems to be important for stress symptoms. Meaning, self-determination, impact and opportunities appear to be important for job satisfaction and competence, opportunities, resources and formal power for quality of care.

Psychosomatic health problems among adolescents in Sweden--are the time trends gender related?

Since the economic recession in Sweden in the 1990s alarming reports about deteriorating mental and psychosomatic health among young people have repeatedly been published but reliable survey data are rare. The purpose of the study is to describe the trends in psychosomatic health problems among adolescents, focusing on gender differences. The analysis is based on repeated cross-sectional data collected 1988-2005 among about 15,000 adolescents (15- to 16-years old) within a county in Sweden. The data were collected in schools using a questionnaire that was completed anonymously. A composite measure of psychosomatic health problems based on eight items was used. Psychosomatic health complaints among boys increased mainly during the in-recession time period, while the health problems among girls increased only slightly during the crisis, but increased dramatically in the post-recession time period. Only among boys did the variance in psychosomatic health increase successively across years of investigation, implying that the psychosomatic health among boys on average did not change over time. In showing different trend patterns across genders, the present study nuances and qualifies previous reports on deteriorating mental and psychosomatic health among adolescents. Whether the gender-related trend patterns are due to differences in the relative influence of economic and social stress factors or if they reflect other factors such as changes in the educational systems should be addressed in future studies.

Solidarity in the neighbourhood, social support at work and psychosomatic health problems

AimsThe aim of this study was to analyse the link between psychosocial factors in the neighbourhood and work environments, and psychosomatic health problems.MethodsThe data were collected in the survey “Life and Health”, which was conducted in 2000 in six Swedish county councils. A total of 71,580 questionnaires were distributed to randomly selected individuals aged 18–79. A total of 46,636 respondents completed the questionnaire. This gives a response rate of around 65%. For the purpose of this study only gainfully employed individuals aged 18–64 are included, which gives a total of 22,164 individuals: 11,247 (50.7%) women and 10,917 (49.3%) men. Two scales were used to measure the psychosocial environments in the neighbourhood and at work. The link between these scales and psychosomatic health problems was analysed by using multinomial logistic regression.ResultsThe results show that both “Psychosocial Neighbourhood Environment” (PNE) and “Psychosocial Working Environment” (PWE), independently, are related to psychosomatic health problems. Hence, the health effects of social relations in the neighbourhood were not modified by the quality of social relations at work, or vice versa. The levels of psychosomatic health problems are highest for people experiencing a low degree of social solidarity in the neighbourhood and for those experiencing low degrees of supportive work relationships.ConclusionThe strong, but independent, effects of social factors related to the neighbourhood and to the workplace on psychosomatic health problems point to the importance of simultaneously considering social relations in different arenas in order to increase the knowledge of the connection between social relations and health.