OBJECTIVE: The somatic presentation of psychic distress among Africans
is different from that in the West, and the prevalence of somatization
symptoms suggests that they could be usefully incorporated in screening
instruments. This report examines the prevalence of somatization symptoms
among users of health care facilities in a rural community in southwestern
Nigeria. It also examines the correlation between the presence of these
symptoms and scores on instruments that assess psychiatric morbidity.
METHOD: Over a 5-month period in 1991, 865 adults using five primary health
care facilities or seeking help from voluntary village health assistants
were assessed with the 28-item General Health Questionnaire and two World
Health Organization instruments, the Self-Reporting Questionnaire and the
Brief Disability Questionnaire. The somatization symptoms investigated
included feelings of heat, peppery and crawling sensations, and numbness.
RESULTS: About 20% of the subjects admitted experiencing at least one
somatization symptom, while 8.2% fulfilled operational criteria for
probable psychiatric "caseness" on the basis of somatization alone. The
rate of caseness according to the General Health Questionnaire was 6.4%.
The presence of any of the somatization symptoms was significantly
correlated with scores on the other test instruments. There were no sex
differences in the pattern of somatization. CONCLUSIONS: These symptoms are
reliable indexes of psychic distress. In this culture, the sensitivity of
standard screening instruments fashioned in the West can be improved by
using these symptoms to replace the somatization symptoms contained in