Department of Psychiatry and Psychotherapy at St Hedwig Hospital, Charité - University Medicine Berlin, Germany. Grosse Hamburger Straße 5-11, 10115 Berlin, Germany. amanda.heredia-
Eur Psychiatry. 2012 Jun;27 Suppl 2:S22-6. doi: 10.1016/S0924-9338(12)75704-8.
Even though some studies suggest that in Mediterranean and non-western cultures more somatic and less psychological symptoms are reported, this so-called 'somatization' hypothesis has been challenged. Reviews show that somatic symptoms are a core component of depressive episodes regardless of cultural background. The expression of symptoms might be related to the psychosocial, social and cultural context surrounding the patient rather than 'ethnicity' or related constructs. Also, stigma associated with mental disorders can affect patients'symptom presentation.
The interrelationships of perceived stigmatization (Explanatory Model Interview Catalogue - Stigma Scale), depression (Beck Depression Index II), overall psychological distress (Symptom Checklist-90-R), and somatic symptoms (The screening for SOMATOFORM SYMPTOMS II) was assessed in a sample of female patients with Turkish descent with a diagnosis of depression (N=63).
Depression, overall psychological distress, and somatic symptoms were positively and significantly related. Stigma was positively related to depression and overall psychological distress. There was no significant relationship between stigma and somatic symptoms, neither among the severely depressed group (N=39), nor among the less depressed group (N=24).
The positive relationships between stigma, depression, and overall psychological distress indicate that patients who are more depressed and who have higher levels of overall psychological distress experience their condition as more stigmatizing. Since somatic symptoms and stigma were not related (neither positively, nor negatively), it appears that depressive symptoms and other symptoms of psychological distress affect concerns about stigmatizing attitudes in a way that somatic symptoms do not. This result challenges common assumption of the 'somatization'hypothesis, i.e. that depression is 'somatized'because of concern about stigmatizing attitudes.
尽管一些研究表明，在地中海和非西方文化中，更多的躯体症状和较少的心理症状被报告，但这种所谓的“躯体化”假说受到了挑战。综述显示，躯体症状是抑郁发作的核心组成部分，无论文化背景如何。症状的表现可能与患者周围的心理社会、社会和文化背景有关，而不是与“种族”或相关结构有关。此外，与精神障碍相关的污名可能会影响患者的症状表现。
在一组具有土耳其血统的被诊断为抑郁症的女性患者（N=63）中，评估了感知污名（解释模型访谈目录-污名量表）、抑郁（贝克抑郁指数 II）、总体心理困扰（症状清单-90-R）和躯体症状（躯体症状筛查 II）之间的相互关系。
抑郁、总体心理困扰和躯体症状呈正相关且显著相关。污名与抑郁和总体心理困扰呈正相关。污名与躯体症状之间没有显著关系，无论是在重度抑郁组（N=39）还是在轻度抑郁组（N=24）中。
污名、抑郁和总体心理困扰之间的正相关关系表明，抑郁程度较高且总体心理困扰水平较高的患者认为自己的病情更具污名化。由于躯体症状和污名之间没有相关性（无论是正相关还是负相关），因此似乎是抑郁症状和其他心理困扰症状以一种躯体症状不会的方式影响对污名化态度的担忧。这一结果挑战了“躯体化”假说的常见假设，即抑郁是由于对污名化态度的担忧而“躯体化”的。
