Racial/ethnic differences in general physical symptoms and medically unexplained physical symptoms: Investigating the role of education
- PMID: 32162934
- PMCID: PMC7486256
- DOI: 10.1037/cdp0000319
Racial/ethnic differences in general physical symptoms and medically unexplained physical symptoms: Investigating the role of education
Abstract
Objectives: Distressing physical symptoms (e.g., back pain, nausea), many of which lack medical explanation, are a common cause for medical help seeking. However, racial/ethnic and educational differences may complicate identification and explanation of such symptoms, potentially contributing to clinician misdiagnosis and patient dissatisfaction. To better understand this issue, we examined racial/ethnic differences in general physical symptoms (GPS) and, more specifically, medically unexplained physical symptoms (MUPS) and whether differences varied by race/ethnicity and educational attainment.
Method: A sample of 4,864 Latino, Asian, and non-Latino White community respondents (54% female; average age of 41 years) self-reported their GPS. Two experts then rated whether endorsed symptoms were likely to have a medical basis. We assessed the associations of GPS and MUPS with race/ethnicity, age, gender, educational attainment, chronic physical conditions, and past-year psychiatric diagnoses.
Results: Asian respondents reported significantly fewer GPS than non-Latino Whites, and both Asian and Latino respondents endorsed significantly fewer MUPS than non-Latino Whites. When nativity and language were each included as covariates, racial/ethnic differences in GPS count were no longer observed; however, observed differences in MUPS count remained. Educational attainment did not demonstrate a significant relationship with either GPS or MUPS. Although comorbid mental health diagnoses were significantly related to both GPS and MUPS, age, gender, and comorbid physical conditions were the only significant predictors of GPS.
Conclusions: Results from this study question existing stereotypical views of racial/ethnic differences in somatization and suggest that educational attainment does not significantly contribute to reported physical symptoms-with or without medical explanation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Conflict of interest statement
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References
-
- American Psychiatric Association. (2013). Highlights of changes from dsm-iv to dsm-5: Somatic symptom and related disorders. FOCUS, 11(4), 525–527.
-
- Assari S (2017). Combined racial and gender differences in the long-term predictive role of education on depressive symptoms and chronic medical conditions. Journal of racial and ethnic health disparities, 4(3), 385–396. - PubMed
-
- Barsky AJ, Orav EJ, & Bates DW (2005). Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Archives of General Psychiatry, 62, 903. - PubMed
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