Somatization symptoms in the community: a rural/urban comparison

Somatization is conceptualized as a bodily or somatic expression of psychic distress. Unexplained somatic symptomatology was assessed by use of the National Institute of Mental Health Diagnostic Interview Schedule among community respondents in the Piedmont of North Carolina participating in the Epidemiologic Catchment Area program. Previous literature suggests that somatization is associated with rural residence, less education, lower socioeconomic class, and particular ethnicities. Through use of a multiple regression analysis, lifetime unexplained somatic-symptom counts were regressed on urban residence and other sociodemographic variables. Rural residence was not associated with somatization; rather, somatization was more common among urban residents. The urban/rural differences were greatest among women and high school graduates. Somatization was also associated with being aged 45 to 64, and being separated, widowed, or divorced; it was not associated with race. Overall, somatization was also associated with less education.