Prevalence and characteristics of somatic symptom disorder in the elderly in a community-based population:.., 2022, Wu et al

Abstract

Introduction and objectives
The aging population is expected to reach 2 billion by 2050, but the impact of somatic symptom disorder (SSD) on the elderly has been insufficiently addressed. We aimed to clarify the prevalence of SSD in China and to identify physical and psychological differences between the elderly and non-elderly.

Methods
In this prospective multi-center study, 9020 participants aged (2206 non-elderly adults and 6814 elderly adults) from 105 communities of Shanghai were included (Assessment of Somatic Symptom in Chinese Community-Dwelling People, clinical trial number NCT04815863, registered on 06/12/2020). The Somatic Symptom Scale-China (SSS-CN) questionnaire was used to measure SSD. Depressive and anxiety disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively.

Results
The prevalence of SSD in the elderly was higher than that in the non-elderly (63.2% vs. 45.3%). The elderly suffered more severe SSD (20.4% moderate and severe in elderly vs. 12.0% in non-elderly) and are 1.560 times more likely to have the disorder (95%CI: 1.399–1.739; p < .001) than the non-elderly. Comorbidity of depressive or anxiety disorders was 3.7 times higher than would be expected in the general population. Additionally, the results of adjusted multivariate analyses identified older age, female sex, and comorbid physical diseases as predictive risk factors of SSD in the elderly group.

Conclusions
With higher prevalence of common physical problems (including hypertension, diabetes mellitus and cardio/cerebrovascular disease), the elderly in Shanghai are more vulnerable to have SSD and are more likely to suffer from comorbid depressive and anxiety disorders. SSD screening should be given more attention in the elderly, especially among older females with several comorbid physical diseases.

Open access, https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-03907-1

 

"However, the diagnostic criteria for somatization disorder defined in the DSM-IV have frequently been criticized as overly restrictive. Therefore, the DSM-5, which emphasizes broader concepts, now defines SSD as “symptoms that are difficult to explain after adequate evaluation; even when a significant medical disease is present.”"

 

This is the stuff that really should give people pause about the validity of this construct. It shows the utter silliness of the ideology. Sadly, it won't. This is an idea that should be rare, in the 1 in thousands. And they find it makes up a supermajority exactly in the population where a... supermajority... have significant health problems.

Surprisingly, inventing a concept that cannot be falsified and explicitly overlaps with things in real life is useless. If it can't be differentiated from the things it is supposed to differentiate, then it cannot. This is as simple as it gets. And yet here we are. In truth this is all no different than living in some weird theocratic state where the state religion has to be infused in everything, for its own sake. It just has to be applied to anything and everything. Madness.

And contrary to the opening line, it has been "addressed" more than sufficiently already, because 0 is plenty sufficient. This isn't worth "addressing" anymore than the exact number of ghosts of aliens past are inhabiting anyone's body, or the precise influence of this or that astrological idea. 0 is the only acceptable number here.

 

A disease like diabetes has lots of little symptoms that are difficult to live with but no one is researching them or looking for treatments because they are not important compared to feet infections or blindness. But they are prime targets for anyone looking for SSD.

Then, as my mother-in-law like to say "Old age doesn't come itself". Vague aches and pains, odd movements, funny turns and feelings, all of them transient and more bother to get investigated than it's worth are all signs of a body that has been through a lot.

And who gets through a lifetime without adverse events? And we all know about the problem with the way questionnaires are used to show depression and anxiety which make physical ailments show as psychological distress.

If any of this actually made a patient's life better it would not be so bad, instead it leads to them getting blamed and not taken seriously if they do have the makings of a life-threatening illness.