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The South London Somatisation Study

II. Influence of Stressful Life Events, and Secondary Gain

Published online by Cambridge University Press:  02 January 2018

T. K. J. Craig ,
H. Drake ,
K. Mills  and
A. P. Boardman
T. K. J. Craig*
Affiliation:
St Thomas' Hospital
K. Mills
Affiliation:
Research & Development for Psychiatry, 134–138 Borough High Street, London SE1 1LB
A. P. Boardman
Affiliation:
Department of Psychiatry, Keele University
*
T. K. J. Craig, Professor of Community Psychiatry, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH
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Abstract

Background.

A study of the influence of life-event stress on the onset and course of acute somatisation in primary care.

Method.

Forty-four somatisers were compared with 11 subjects who had psychiatric disorder but complained only of psychological symptoms, 39 patients who had ‘mixed’ conditions involving independent physical and psychiatric illness, 90 patients who had physical illness, and 123 healthy members of the general population.

Results.

Severely threatening life events were more common among all subjects with psychiatric disorder. A novel contextual rating of the potential of stressors to produce symptoms for ‘secondary gain’ was developed. In the 38 weeks before symptom onset, somatisers and psychologisers were more likely to have experienced at least one event which had this potential. Somatisers were also less likely to adopt neutralising coping efforts when faced with such a crisis.

Conclusions.

The likelihood of adopting neutralising efforts was closely related to the presence of a joint index of parental problems in care and exposure to physical illness in the subject's childhood. In a two-year follow-up, subsequent functional illnesses were also associated with experiences which had secondary-gain potential, and subjects with childhood risk factors continued to have higher rates of crises with secondary-gain potential and to fail to adopt neutralising coping strategies.

Type
Papers
Information
The British Journal of Psychiatry , Volume 165 , Issue 2 , August 1994 , pp. 248 - 258
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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