Of a total of 4864 respondents, 1649 (33.6%) reported the presence of at least one frequent and severe GPS and 507 (11.8%) reported the presence of at least one frequent and severe MUPS leading to a medical visit during the previous year. 526 (10.7%) respondents reported 3 or more frequent/severe GPS and 66 (1.5%) respondents reported 3 or more frequent/severe MUPS during the same period. An analysis of individual symptoms (not shown) showed that the most frequent GPS were back pain (11.9%), pain in arms, legs, joints (11.0%), stomach pain (9.0%), menstrual pain (7.2%) and diarrhea (6.6%). Also, the most common MUPS were stomach pain (2.6%), diarrhea (2.2%), heart pounding/racing (2.1%), menstrual pain (1.9%) and shortness of breath (1.6%). The association between GPS and MUPS was 0.60.
presents the characteristics of the total sample and compares individuals with less than 3 physical symptoms to individuals with greater than or equal to 3 physical symptoms. Using chi-square tests of significance, we found significant differences among the racial/ethnic groups in number of GPS reported. In addition, differences in having 3 or more physical symptoms were found by age, gender, marital status, employment status, and among those with any chronic physical condition.
provides a descriptive table of GPS and MUPS and their relation to past year rates of depressive, anxiety disorders and use of services. This table allows for a qualitative look at the rates associated with GPS and MUPS. Increases in rates from left to right are indicative of GPS association with psychopathology/service use, while increases from top to bottom are indicative of the level of prediction that MUPS add to GPS. For both GPS and MUPS, the predominant trend was that as number of somatic symptoms increased so did the prevalence of psychopathology and use of mental health services during the past year. Relative to GPS, MUPS symptoms seem to add some predictive value for psychopathology and service use, as rates were highest among those with large numbers of MUPS and GPS. The relationship between number of somatic symptoms and psychopathology was particularly salient for anxiety disorders.
shows that after adjustment for age, gender, ethnicity, SES variables, and chronic physical conditions, individuals with 3 or more GPS had significantly greater odds of having any last year depressive disorder (OR=2.57), any last year anxiety disorder (OR=3.60), any last year substance use disorder (OR=3.27), any last year generalist treatment for a mental health problem (OR=3.70), and any last year mental health service use (OR=2.94). After adjusting for GPS, the independent contribution of having 3 or more MUPS was not significantly associated with diagnosis of psychiatric disorder. Having 5 or more somatic symptoms was relatively rare (GPS 4.2% and MUPS 0.4%), but because this level had been suggested as a cut-off in previous studies, we conducted sensitivity analyses using 5+ GPS and 5+MUPS. This produced identical results for diagnoses of depression, anxiety and service use variables. Contrary to findings from the 3+ GPS analysis, no significant association was found between 5 or more GPS and substance use disorders and a negative association was found between levels of MUPS and service use.
When we examined the effect of ethnic background in the five regression models, we found that Asians were significantly less likely than Whites to meet criteria for a current anxiety disorder and substance use disorder, and were less likely to use generalist service. Both Asians and Latinos reported significantly less use of mental health services for mental health problems than Whites. Summing up results from other covariates in the regression models, we found that individuals who were older, married, employed, and without any chronic physical health disorder had significantly reduced odds of having a mental disorder during the past year compared to subjects who were younger, unmarried, unemployed and who reported a chronic physical health condition. In addition, females were less likely than males were to meet criteria for a current substance abuse disorder and individuals who were older, unmarried, unemployed, out of the labor force, and who reported having a chronic physical health condition, had significantly higher odds for using mental health services during the previous year.
shows that number of GPS was positively associated with psychological distress as measured by the K10 scale, after adjustment for age, gender, ethnicity, SES variables, and any chronic physical condition. In the same analysis, we found no significant independent association of number of MPS after adjustment for GPS and other covariates.