Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1985 Sep;75(9):1080–1084. doi: 10.2105/ajph.75.9.1080

An exploration of somatization among Asian refugees and immigrants in primary care.

E H Lin, W B Carter, A M Kleinman
PMCID: PMC1646334  PMID: 4025659

Abstract

The clinical records of Chinese, Filipino, Vietnamese, Laotian, and Mien patients in primary care were reviewed to determine the prevalence of somatization, its associated patient characteristics, and the manifested illness behavior. Patients in this study were generally poor, unemployed, and spoke little English. Somatization accounted for 35 per cent of illness visits. These visits were also more costly. Refugees had a higher rate of somatization (42.7 per cent) than immigrants (27.1 per cent). Although sociodemographic characteristics did not strongly differentiate patients with somatization from others, ethnicity and indicators of decreased resources such as large households with low income, households headed by single women, or a limited English proficiency were associated with somatization in certain ethnic groups. Somatization is thus an important health problem among Asian refugees and immigrants.

Full text

PDF
1080

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barsky A. J., Klerman G. L. Overview: hypochondriasis, bodily complaints, and somatic styles. Am J Psychiatry. 1983 Mar;140(3):273–283. doi: 10.1176/ajp.140.3.273. [DOI] [PubMed] [Google Scholar]
  2. Cheung F. M., Lau B. W., Waldmann E. Somatization among Chinese depressives in general practice. Int J Psychiatry Med. 1980;10(4):361–374. doi: 10.2190/bvy5-yccr-ct1v-20fr. [DOI] [PubMed] [Google Scholar]
  3. Climent C. E., Diop B. S., Harding T. W., Ibrahim H. H., Ladrido-Ignacio L., Wig N. N. Mental health in primary health care. WHO Chron. 1980 Jun;34(6):231–236. [PubMed] [Google Scholar]
  4. Collyer J. A. Psychosomatic illness in a solo family practice. Psychosomatics. 1979 Nov;20(11):762-3, 767. doi: 10.1016/S0033-3182(79)73739-X. [DOI] [PubMed] [Google Scholar]
  5. Cummings N. A., VandenBos G. R. The twenty years Kaiser-Permanente experience with psychotherapy and medical utilization: implications for national health policy and national health insurance. Health Policy Q. 1981 Summer;1(2):159–175. [PubMed] [Google Scholar]
  6. Garfield S. R., Collen M. F., Feldman R., Soghikian K., Richart R. H., Duncan J. H. Evaluation of an ambulatory medical-care delivery system. N Engl J Med. 1976 Feb 19;294(8):426–431. doi: 10.1056/NEJM197602192940806. [DOI] [PubMed] [Google Scholar]
  7. Good B. J. The heart of what's the matter. The semantics of illness in Iran. Cult Med Psychiatry. 1977 Apr;1(1):25–58. doi: 10.1007/BF00114809. [DOI] [PubMed] [Google Scholar]
  8. Hilkevitch A. Psychiatric disturbances in outpatients of a general medical outpatient clinic. Int J Neuropsychiatry. 1965 Aug;1(4):371–375. [PubMed] [Google Scholar]
  9. Hoeper E. W., Nycz G. R., Regier D. A., Goldberg I. D., Jacobson A., Hankin J. Diagnosis of mental disorder in adults and increased use of health services in four outpatient settings. Am J Psychiatry. 1980 Feb;137(2):207–210. doi: 10.1176/ajp.137.2.207. [DOI] [PubMed] [Google Scholar]
  10. Hull D. Migration, adaptation, and illness: a review. Soc Sci Med Med Psychol Med Sociol. 1979 Jan;13A(1):25–36. doi: 10.1016/0160-7979(79)90005-5. [DOI] [PubMed] [Google Scholar]
  11. Katon W., Kleinman A., Rosen G. Depression and somatization: a review. Part II. Am J Med. 1982 Feb;72(2):241–247. doi: 10.1016/0002-9343(82)90816-6. [DOI] [PubMed] [Google Scholar]
  12. Katon W., Ries R. K., Kleinman A. The prevalence of somatization in primary care. Compr Psychiatry. 1984 Mar-Apr;25(2):208–215. doi: 10.1016/0010-440x(84)90009-9. [DOI] [PubMed] [Google Scholar]
  13. Kinzie J. D., Manson S. M., Vinh D. T., Tolan N. T., Anh B., Pho T. N. Development and validation of a Vietnamese-language depression rating scale. Am J Psychiatry. 1982 Oct;139(10):1276–1281. doi: 10.1176/ajp.139.10.1276. [DOI] [PubMed] [Google Scholar]
  14. Kleinman A. M. Depression, somatization and the "new cross-cultural psychiatry". Soc Sci Med. 1977 Jan;11(1):3–10. doi: 10.1016/0037-7856(77)90138-x. [DOI] [PubMed] [Google Scholar]
  15. Kleinman A. Neurasthenia and depression: a study of somatization and culture in China. Cult Med Psychiatry. 1982 Jun;6(2):117–190. doi: 10.1007/BF00051427. [DOI] [PubMed] [Google Scholar]
  16. Lin E. H., Ihle L. J., Tazuma L. Depression among Vietnamese refugees in a primary care clinic. Am J Med. 1985 Jan;78(1):41–44. doi: 10.1016/0002-9343(85)90459-0. [DOI] [PubMed] [Google Scholar]
  17. Lin K. M., Tazuma L., Masuda M. Adaptational problems of Vietnamese refugees. I. Health and mental health status. Arch Gen Psychiatry. 1979 Aug;36(9):955–961. doi: 10.1001/archpsyc.1979.01780090041005. [DOI] [PubMed] [Google Scholar]
  18. Lowy F. H. Management of the persistent somatizer. Int J Psychiatry Med. 1975;6(1-2):227–239. doi: 10.2190/QP8D-GP4V-YBWA-9VEH. [DOI] [PubMed] [Google Scholar]
  19. Mechanic D. The experience and reporting of common physical complaints. J Health Soc Behav. 1980 Jun;21(2):146–155. [PubMed] [Google Scholar]
  20. Muecke M. A. In search of healers--Southeast Asian refugees in the American health care system. West J Med. 1983 Dec;139(6):835–840. [PMC free article] [PubMed] [Google Scholar]
  21. Nguyen S. D. Psychiatric and psychosomatic problems among Southeast Asian refugees. Psychiatr J Univ Ott. 1982 Sep;7(3):163–172. [PubMed] [Google Scholar]
  22. Nichter M. Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India. Cult Med Psychiatry. 1981 Dec;5(4):379–408. doi: 10.1007/BF00054782. [DOI] [PubMed] [Google Scholar]
  23. Pasquarelli G. The general medical and associated problems of the Italian migrant family. Med J Aust. 1966 Jan 8;1(2):65–70. doi: 10.5694/j.1326-5377.1966.tb19623.x. [DOI] [PubMed] [Google Scholar]
  24. Regier D. A., Goldberg I. D., Taube C. A. The de facto US mental health services system: a public health perspective. Arch Gen Psychiatry. 1978 Jun;35(6):685–693. doi: 10.1001/archpsyc.1978.01770300027002. [DOI] [PubMed] [Google Scholar]
  25. STOECKLE J. D., ZOLA I. K., DAVIDSON G. E. THE QUANTITY AND SIGNIFICANCE OF PSYCHOLOGICAL DISTRESS IN MEDICAL PATIENTS. SOME PRELIMINARY OBSERVATIONS ABOUT THE DECISION TO SEEK MEDICAL AID. J Chronic Dis. 1964 Oct;17:959–970. doi: 10.1016/0021-9681(64)90165-1. [DOI] [PubMed] [Google Scholar]
  26. Tessler R., Mechanic D. Psychological distress and perceived health status. J Health Soc Behav. 1978 Sep;19(3):254–262. [PubMed] [Google Scholar]
  27. Widmer R. B., Cadoret R. J. Depression in primary care: changes in pattern of patient visits and complaints during a developing depression. J Fam Pract. 1978 Aug;7(2):293–302. [PubMed] [Google Scholar]
  28. Widmer R. B., Cadoret R. J. Depression: the great imitator in family practice. J Fam Pract. 1983 Sep;17(3):485-6, 495-8, 503-5. [PubMed] [Google Scholar]
  29. Zola I. K. Culture and symptoms--an analysis of patients' presenting complaints. Am Sociol Rev. 1966 Oct;31(5):615–630. [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES