Objectives: Population studies in Western cultures agree that gender differences influence somatization, while available data on marital status are more conflicting. Previous surveys on immigrants found high levels of somatization, particularly in South/Central Americans, gender effect deserving further research. This study investigates the effect of gender and marital status on somatization in immigrants of four ethnic groups (Caucasians, Asians, South/Central Americans, and Africans). Methods: We studied 360 consecutive outpatients attending a primary care unit for immigrants. 301 completed the 21 item Bradford Somatic Inventory (BSI-21). The BSI-21 total score and the relative risk for any single symptom were studied, adjusting for major intervening variables. Results: Female gender predicted the frequency of 12 out of 21 symptoms and was associated with the total score at the BSI-21. BSI-21 scores were significantly higher in married subjects. Differences were found among the four groups, only Caucasian and South/Central American women and Caucasian married subjects having a significantly increased risk for somatization. Significant ethnic differences were also found in the number and kind of reported symptoms. Conclusion: These differences among ethnic groups suggest that cultural influences might be more relevant than biological factors for the understanding of gender and marital differences in somatization. Future studies should focus on the role of cultural gender differences in social roles and construction of identity as possible basic factors influencing somatization.

Migration Transcultural psychiatry Somatoform disorders Ethnicity Epidemiology somatization

immigrant Negro Asian primary medical care weakness Caucasian human sex difference psychologic assessment ethnic group controlled study outpatient neck pain shoulder pain marriage Hispanic headache male female xerostomia cultural factor symptom sweating scoring system Article major clinical study adult Angina Pectoris airway obstruction heart palpitation thorax pain Constipation somatization social behavior