The epidemiology of multiple somatic symptoms

Francis H. Creed*, Ian Davies, Judy Jackson, Alison Littlewood, Carolyn Chew-Graham, Barbara Tomenson, Gary Macfarlane, Arthur Barsky, Wayne Katon, John McBeth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

162 Citations (Scopus)


Background: The risk factors for a high total somatic symptom count are unclear; and it is not known whether total somatic symptoms count is a predictor of impaired health status. Method: A prospective population-based cohort study in North West England. Randomly sampled residents (1443 participants; 58% response) completed questionnaires to determine number of somatic symptoms (SSI), health status and a wide range of risk factors; 741 completed questionnaires 1. year later. We used logistic regression to identify risk factors for high SSI at follow-up and for persistently high SSI. We used ANCOVAR and multiple regression to assess whether baseline SSI predicted health status at follow-up. Results: Twenty-one percent of participants scored over 25 on the Somatic Symptom Inventory (SSI) at baseline and 14% at both baseline and follow-up. Risk factors for a persistent high SSI were: fewer than 12. years of education, separated, widowed or divorced status, reported psychological abuse during childhood, co-existing medical illnesses, anxiety and depression. In multivariate analysis baseline SSI predicted health status (SF12 physical component score and health-related quality of life (EuroQol)) 12. months later. Persistent high SSI was a clinically meaningful predictor of these outcomes. Conclusions: Our data support a biopsychosocial approach to somatic symptoms rather than the dualistic approach of identifying "medically unexplained" symptoms. The risk factors for total somatic symptom count were those associated with psychiatric disorders including physical illness. A persistent high somatic symptom count provides a readily measured dimension of importance in epidemiology as a predictor of health status.

Original languageEnglish
Pages (from-to)311-317
Number of pages7
JournalJournal of Psychosomatic Research
Issue number4
Early online date2 Feb 2012
Publication statusPublished - Apr 2012

Bibliographical note

We are grateful to the participants in the project and to the General Practitioners who facilitated it.
All authors had full access to all the data in the study, have been involved in drafting and/or revising the article critically and given final approval of the version to be published. The corresponding author takes responsibility for the integrity of the data and the accuracy of the data analysis.
The study was funded by the UK Medical Research Council grant No G0500272. The UK MRC had no role in study design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.


  • Epidemiology
  • Health-related quality of life
  • Somatisation
  • Somatoform disorders


Dive into the research topics of 'The epidemiology of multiple somatic symptoms'. Together they form a unique fingerprint.

Cite this