Medical Psychology in Southern Africa: Future Concerns in the General Teaching Hospital

The challenge facing the contribution of clinical psychology to general health care from within the medical teaching establishment, in a changing society, is explored. Factors providing an impetus for psychology to participate in the quest for a mind — body synthesis in understanding and treating physical disease are discussed, along with related joint collaborative and other psychological aspects. The importance of cross-cultural issues and implications for future training and functioning of clinical psychologists within the general teaching hospital are mentioned.

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Gender and cross-cultural differences in somatic symptoms associated with emotional distress. An international study in primary care

Psychological Medicine ◽

10.1017/s0033291796004539 ◽

1997 ◽

Vol 27 (2) ◽

pp. 433-444 ◽

Cited By ~ 90

Author(s):

MARCO PICCINELLI ◽

GREGORY SIMON

Keyword(s):

Primary Care ◽

Health Care ◽

Cultural Differences ◽

Emotional Distress ◽

General Health ◽

Somatic Symptoms ◽

Cross Cultural ◽

World Health ◽

Cross Cultural Differences ◽

The World

Background. Gender and cross-cultural differences in the association between somatic symptoms and emotional distress were investigated, using data from the World Health Organization Collaborative Project on Psychological Problems in General Health Care.Methods. Data were collected at 15 centres in 14 countries around the world. At each centre, a stratified random sample of primary care attenders aged 15–65 years was assessed using, among other instruments, the 28-item General Health Questionnaire and the Composite International Diagnostic Interview-Primary Health Care Version.Results. Females reported higher levels of somatic symptoms and emotional distress than males. A strong correlation between somatic symptoms and emotional distress was found in both sexes, with females reporting more somatic symptoms at each level of emotional distress. However, linear regression analysis showed that gender had no significant effect on level of somatic symptoms, when the effects of centre and emotional distress were controlled for. In both sexes, no specific pattern of association emerged between somatic symptom clusters and either anxiety or depression. Primary care attenders from less developed centres reported more somatic symptoms and showed greater gender differences than individuals from more developed centres, but inter-centre differences were small. Finally, gender was not a significant predictor of reason for consultation (somatic versus mental/behavioural symptoms), after controlling for levels of somatic symptoms and emotional distress as well as for centre effect.Conclusions. These data do not support the common belief that females somatize more than males or the traditional view that somatization is a basic orientation prevailing in developing countries. Instead, somatic symptoms and emotional distress are strongly associated in primary care attenders, with few differences between the two sexes and across cultures.

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