{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:58:07Z","timestamp":1792544287873,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T00:00:00Z","timestamp":1552521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T00:00:00Z","timestamp":1552521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The purpose of the study was (1) to determine the prevalence of somatic symptoms in men and women in the general population and (2) to identify the contributions of psychosocial factors and somatic disease on symptom reporting. A total of 7,925 participants aged 40 to 80 years underwent medical and psychological assessments, based on the PHQ-15 (Patient Health Questionnaire). We excluded 3 items in order to avoid confounding findings: 2 items overlapping with the depression measure (PHQ-9) and the menstruation complaints item which biases sex comparisons. Pain complaints (arms, legs, joints, back pain) affected the majority of men and women, and somatic symptom reporting increased with age. When confounding has been reduced, psychosocial factors (lack of social support, adverse life events, loneliness, depression, generalized anxiety, panic, social phobia) have remained the strongest predictors of somatic symptoms. As shown by the interaction between sex and depression, depression plays a smaller role for somatic symptom reporting in women vs. men. Findings highlight the complex psychosocial and somatic contributions to somatic symptom reporting.<\/jats:p>","DOI":"10.1038\/s41598-019-40709-0","type":"journal-article","created":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T12:06:06Z","timestamp":1552565166000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Somatic symptom load in men and women from middle to high age in the Gutenberg Health Study - association with psychosocial and somatic factors"],"prefix":"10.1038","volume":"9","author":[{"given":"Manfred E.","family":"Beutel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Wiltink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Ghaemi Kerahrodi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana N.","family":"Tibubos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Br\u00e4hler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Wild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Lackner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4683-0360","authenticated-orcid":false,"given":"Jochem","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Pfeiffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Michal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Henning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,3,14]]},"reference":[{"key":"40709_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.jpsychores.2016.12.017","volume":"96","author":"A Hinz","year":"2017","unstructured":"Hinz, A. et al. Frequency of somatic symptoms in the general population: Normative values for the Patient Health Questionnaire-15 (PHQ-15). Psychosom Res. 96, 27\u201331 (2017).","journal-title":"Psychosom Res."},{"key":"40709_CR2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-13-91","volume":"13","author":"RD Kocalevent","year":"2013","unstructured":"Kocalevent, R. D., Hinz, A. & Br\u00e4hler, E. Standardization of a screening instrument (PHQ-15) for somatization syndromes in the general population. BMC psychiatry 13, 91 (2013).","journal-title":"BMC psychiatry"},{"issue":"4","key":"40709_CR3","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/j.jpsychores.2012.01.009","volume":"72","author":"FH Creed","year":"2012","unstructured":"Creed, F. H. et al. The epidemiology of multiple somatic symptoms. J Psychosom Res. 72(4), 311\u20137 (2012).","journal-title":"J Psychosom Res."},{"issue":"3","key":"40709_CR4","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1001\/jamainternmed.2013.12179","volume":"174","author":"B Gierk","year":"2014","unstructured":"Gierk, B. et al. The somatic symptom scale-8 (SSS-8): a brief measure of somatic symptom burden. JAMA internal medicine. 174(3), 399\u2013407 (2014).","journal-title":"JAMA internal medicine."},{"key":"40709_CR5","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.jpsychores.2017.02.003","volume":"95","author":"S Kliem","year":"2017","unstructured":"Kliem, S. et al. Brief assessment of subjective health complaints: Development, validation and population norms of a brief form of the Giessen Subjective Complaints List (GBB-8). J Psychosom Res. 95, 33\u201343 (2017).","journal-title":"J Psychosom Res."},{"issue":"3","key":"40709_CR6","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.genhosppsych.2008.01.001","volume":"30","author":"B L\u00f6we","year":"2008","unstructured":"L\u00f6we, B. et al. Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. Gen Hosp Psychiatry 30(3), 191\u20139 (2008).","journal-title":"Gen Hosp Psychiatry"},{"key":"40709_CR7","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.jpsychores.2016.02.007","volume":"85","author":"FH Creed","year":"2016","unstructured":"Creed, F. H. Exploding myths about medically unexplained symptoms. J Psychosom Res. 85, 91\u20133 (2016).","journal-title":"J Psychosom Res."},{"issue":"9565","key":"40709_CR8","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1016\/S0140-6736(07)60159-7","volume":"369","author":"P Henningsen","year":"2007","unstructured":"Henningsen, P., Zipfel, S. & Herzog, W. Management of functional somatic syndroms. Lancet 369(9565), 946\u201355 (2007).","journal-title":"Lancet"},{"key":"40709_CR9","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders DSM-5 (American Psychiatric Press, 2013).","DOI":"10.1176\/appi.books.9780890425596"},{"key":"40709_CR10","unstructured":"L\u00f6we, B., Zipfel, S., Herzog, W. Gesundheitsfragebogen f\u00fcr Patienten (PHQ D). Komplettversion und Kurzform. Testmappe mit Manual, Frageb\u00f6gen, Schablonen. 2nd edition (Pfizer, 2002)."},{"issue":"7","key":"40709_CR11","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1176\/ajp.154.7.989","volume":"154","author":"O Gureje","year":"1997","unstructured":"Gureje, O., Simon, G. E., Ustun, T. B. & Goldberg, D. P. Somatization in cross-cultural perspective: a World Health Organization study in primary care. Am J Psychiatry. 154(7), 989\u201395 (1997).","journal-title":"Am J Psychiatry."},{"key":"40709_CR12","first-page":"216","volume":"61","author":"HU Wittchen","year":"1999","unstructured":"Wittchen, H. U., Muller, N., Pfister, H., Winter, S. & Schmidtkunz, B. Affective, somatoform and anxiety disorders in Germany\u2013initial results of an additional federal survey of \u201cpsychiatric disorders\u201d. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)). 61, 216\u201322 (1999).","journal-title":"Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))."},{"issue":"4","key":"40709_CR13","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1046\/j.1525-1497.2001.016004266.x","volume":"16","author":"AJ Barsky","year":"2001","unstructured":"Barsky, A. J., Peekna, H. M. & Borus, J. F. Somatic symptom reporting in women and men. J Gen Intern Med. 16(4), 266\u201375 (2001).","journal-title":"J Gen Intern Med."},{"issue":"3","key":"40709_CR14","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1002\/mpr.1439","volume":"23","author":"F Jacobi","year":"2014","unstructured":"Jacobi, F. et al. Twelve-month prevalence, comorbidity and correlates of mental disorders in Germany: the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH). International journal of methods in psychiatric research. 23(3), 304\u201319 (2014).","journal-title":"International journal of methods in psychiatric research."},{"issue":"9\u201310","key":"40709_CR15","first-page":"378","volume":"64","author":"ME Beutel","year":"2014","unstructured":"Beutel, M. E. et al. Unhealthy lifestyle in patients of a psychosomatic outpatient and consultation-liaison clinic. Psychother Psychosom Med Psychol. 64(9\u201310), 378\u201383 (2014).","journal-title":"Psychother Psychosom Med Psychol."},{"issue":"9","key":"40709_CR16","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke, K., Spitzer, R. L. & Williams, J. B. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 16(9), 606\u201313 (2001).","journal-title":"J Gen Intern Med."},{"issue":"5","key":"40709_CR17","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1037\/hea0000467","volume":"36","author":"AS LeRoy","year":"2017","unstructured":"LeRoy, A. S., Murdock, K. W., Jaremka, L. M., Loya, A. & Fagundes, C. P. Loneliness predicts self-reported cold symptoms after a viral challenge. Health Psychol. 36(5), 512\u2013520 (2017).","journal-title":"Health Psychol."},{"issue":"4","key":"40709_CR18","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.genhosppsych.2010.03.006","volume":"32","author":"K Kroenke","year":"2010","unstructured":"Kroenke, K., Spitzer, R. L., Williams, J. B. & L\u00f6we, B. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry 32(4), 345\u2013359 (2010).","journal-title":"Gen Hosp Psychiatry"},{"key":"40709_CR19","doi-asserted-by":"publisher","DOI":"10.1186\/1744-859X-10-32","volume":"10","author":"A Tselebis","year":"2011","unstructured":"Tselebis, A. Psychological symptom patterns and vital exhaustion in outpatients with chronic obstructive pulmonary disease. Ann Gen Psychiatry 10, 32 (2011).","journal-title":"Ann Gen Psychiatry"},{"key":"40709_CR20","doi-asserted-by":"crossref","unstructured":"Serber, E. R. et al. Prevalence of Chest Pain, Depression, Somatization, Anxiety, Global Distress, and Substance Use among Cardiac and Pulmonary Rehabilitation Patients. Pain Res Treat 138680 (2012).","DOI":"10.1155\/2012\/138680"},{"issue":"1\u20132","key":"40709_CR21","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.jad.2009.06.019","volume":"122","author":"B L\u00f6we","year":"2010","unstructured":"L\u00f6we, B. et al. A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 122(1\u20132), 86\u201395 (2010).","journal-title":"J Affect Disord."},{"issue":"Pt A","key":"40709_CR22","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.neubiorev.2017.01.015","volume":"74","author":"O Van den Bergh","year":"2017","unstructured":"Van den Bergh, O., Witthoft, M., Petersen, S. & Brown, R. J. Symptoms and the body: Taking the inferential leap. Neuroscience and biobehavioral reviews 74(Pt A), 185\u2013203 (2017).","journal-title":"Neuroscience and biobehavioral reviews"},{"issue":"6","key":"40709_CR23","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.jpsychores.2013.03.093","volume":"74","author":"WL Zijlema","year":"2013","unstructured":"Zijlema, W. L. et al. How to assess common somatic symptoms in large-scale studies: a systematic review of questionnaires. J Psychosom Res 74(6), 459\u2013468 (2013).","journal-title":"J Psychosom Res"},{"issue":"6\u20137","key":"40709_CR24","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1007\/s00103-012-1502-7","volume":"55","author":"PS Wild","year":"2012","unstructured":"Wild, P. S. et al. The Gutenberg Health Study. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 55(6\u20137), 824\u20139 (2012).","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"issue":"2","key":"40709_CR25","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1097\/00006842-200203000-00008","volume":"64","author":"K Kroenke","year":"2002","unstructured":"Kroenke, K., Spitzer, R. L. & Williams, J. B. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med 64(2), 258\u2013266 (2002).","journal-title":"Psychosom Med"},{"issue":"12","key":"40709_CR26","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1097\/00005650-200412000-00006","volume":"42","author":"B L\u00f6we","year":"2004","unstructured":"L\u00f6we, B., Un\u00fctzer, J., Callahan, C. M., Perkins, A. J. & Kroenke, K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 42(12), 1194\u2013201 (2004).","journal-title":"Med Care."},{"issue":"5","key":"40709_CR27","doi-asserted-by":"publisher","first-page":"317","DOI":"10.7326\/0003-4819-146-5-200703060-00004","volume":"146","author":"K Kroenke","year":"2007","unstructured":"Kroenke, K., Spitzer, R. L., Williams, J. B., Monahan, P. O. & L\u00f6we, B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 146(5), 317\u201325 (2007).","journal-title":"Ann Intern Med."},{"issue":"6","key":"40709_CR28","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/S0022-3999(03)00072-2","volume":"55","author":"B L\u00f6we","year":"2003","unstructured":"L\u00f6we, B. et al. Detecting panic disorder in medical and psychosomatic outpatients: comparative validation of the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire, a screening question, and physicians\u2019 diagnosis. J Psychosom Res. 55(6), 515\u20139 (2003).","journal-title":"J Psychosom Res."},{"key":"40709_CR29","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1545-2","volume":"17","author":"J Wiltink","year":"2017","unstructured":"Wiltink, J. et al. Mini - social phobia inventory (mini-SPIN): psychometric properties and population based norms of the German version. BMC Psychiatry 17, 377 (2017).","journal-title":"BMC Psychiatry"},{"issue":"1","key":"40709_CR30","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1262-x","volume":"17","author":"ME Beutel","year":"2017","unstructured":"Beutel, M. E. et al. Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry. 17(1), 97 (2017).","journal-title":"BMC Psychiatry."},{"issue":"12","key":"40709_CR31","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1016\/S0895-4356(03)00220-8","volume":"56","author":"GC Wendel-Vos","year":"2003","unstructured":"Wendel-Vos, G. C., Schuit, A. J., Saris, W. H. & Kromhout, D. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 56(12), 1163\u20139 (2003).","journal-title":"J Clin Epidemiol."},{"key":"40709_CR32","doi-asserted-by":"crossref","unstructured":"InterAct Consortium et al. Validity of a short questionnaire to assess physical activity in 10 European countries. Eur J Epidemiol. 27(1), 15\u201325 (2012).","DOI":"10.1007\/s10654-011-9625-y"},{"issue":"1","key":"40709_CR33","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s00103-012-1583-3","volume":"56","author":"T Lampert","year":"2013","unstructured":"Lampert, T., Kroll, L. E., M\u00fcters, S. & Stolzenberg, H. Measurement of the socioeconomic status within the German Health Update 2009 (GEDA). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 56(1), 131\u201343 (2013).","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz."},{"issue":"1","key":"40709_CR34","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1177\/1557988315623993","volume":"12","author":"JB Call","year":"2018","unstructured":"Call, J. B. & Shafer, K. Gendered Manifestations of Depression and Help Seeking Among Men. American Journal of Men\u2019s Health. 12(1), 41\u201351 (2018).","journal-title":"American Journal of Men\u2019s Health."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-40709-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-40709-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-40709-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T07:39:53Z","timestamp":1671262793000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-40709-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,14]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["40709"],"URL":"https:\/\/doi.org\/10.1038\/s41598-019-40709-0","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,14]]},"assertion":[{"value":"5 September 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 March 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"P.S. Wild has received research funding from Boehringer Ingelheim, PHILIPS Medical Systems, Sanofi-Aventis, Bayer Vital, Daiichi Sankyo Europe, IMO Institute, Portavita, the Federal Institute for Occupational Safety and Health (BAuA), Initiative \u2018Health Economy\u2019, the Ministry of Health and Ministry of Economics, Rhineland-Palatinate, the Federal Ministry of Education and Research, the Federal Ministry of Education and Research (BMBF 01EO1053), Rhineland-Palatinate (MSAGD), and Mainz Heart Foundation, and has received honoraria for lectures or consulting from Boehringer Ingelheim and Public Health, Heinrich-Heine- University D\u00fcsseldorf. P.S. Wild and T. M\u00fcnzel are PIs of the German Center for Cardiovascular Research (DZHK). The other authors state that they have no conflict of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"4610"}}