Background: Chronic pain disorder is assumed to represent a frequent and disabling condition. However, data on the prevalence of somatoform pain symptoms and somatoform pain disorder in the community are limited to date. Methods: German versions of the Composite International Diagnostic Interview were administered to a representative national sample of 4,075 people. Somatoform pain disorder was diagnosed by standardized diagnostic algorithm based on the DSM-III-R criteria (absence of adequate physical findings). One subgroup was identified as also meeting the DSM-IV criterion B for ‘significant distress or psychosocial impairment due to the somatoform pain’. Results: A lifetime prevalence rate of somatoform pain disorder according to DSM-III-R of 33.7% and a 6-month rate of 17.3% was found. When applying the DSM-IV B criterion, the prevalence rate dropped to 12.3 and 5.4%, respectively. In both groups more than 95% of the probands had contacted their doctor because of the pain. In 25% of the probands the pain was positively assigned to psychological factors. A female:male ratio of 2:1 was found. Conclusions: Somatoform pain disorder (DSM-III-R) is a frequent condition. However, only about one third of these subjects is severely distressed or impaired by the pain. A clear operationalized concept of the DSM-IV criterion C ‘psychological factors are judged to have an important role in the onset, severity, exacerbation or maintenance of the pain’ should be provided in the further development of the diagnosis ‘pain disorder’ in order to make this diagnosis suitable for general population surveys.

Crook J, Rideout E, Browne G: The prevalence of pain complaints in a general population. Pain 1984;18:299–314.
Sternbach RA: Pain and ‘hassles’ in the United States: Findings of the Nuprin pain report. Pain 1986;27:69–80.
Rasmussen NH, Avant RF: Somatization disorder in family practice. Am Fam Physician 1989;40:206–214.
Macfarlane GJ, Morris S, Hunt IM, Benjamin S, McBeth J, Papageorgiou AC, Silman AJ: Chronic widespread pain in the community: The influence of psychological symptoms and mental disorder on healthcare seeking behavior. J Rheumatol 1999;26:413–419
Elliot AM, Smith BH, Penny KI, Smith WC, Chambers WA: The epidemiology of chronic pain in the community. Lancet 1999;354:1248–1252.
Newton W, Curtis P, Witt P, Hobler K: Prevalence of subtypes of low back pain in a defined population. J Fam Pract 1997;45:331–335.
Hunt IM, Silman AJ, Benjamin S, McBeth J, Macfarlane GJ: The prevalence and associated features of chronic widespread pain in the community using the ‘Manchester’ definition of chronic widespread pain. Rheumatology 1999;38:275–279.
Andersson GB: Epidemiological features of chronic low back pain. Lancet 1999;354:581–585.
Von Korff M, Dworkin SF, Le Resche L, Kruger A: An epidemiologic comparison of pain complaints. Pain 1988;32:173–183.
Brattberg G, Thorslund M, Wikman A: The prevalence of pain in the general population. The results of a postal survey in a county of Sweden. Pain 1989;37:215–222.
Faravelli C, Salvatori S, Galassi F, Aiazzi L, Drei C, Cabras P: Epidemiology of somatoform disorders: A community survey in Florence. Soc Psychiatry Psychiatr Epidemiol 1997;32:24–29.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3, revised. Washington, American Psychiatric Association, 1987.
Wittchen HU, Beloch E, Garczynski E: Munich Composite International Diagnostic Interview (M-CIDI), Version 2.2, Munich, Max-Planck-Institut für Psychiatrie, 1995.
Wittchen HU, Lachner G, Wunderlich U, Pfister H: Test-retest reliability of the computerized DSM-IV version of the Munich Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 1998;33:568–578.
Meyer C, Rumpf H-J, Hapke U, John U: The Composite International Diagnostic Interview: Feasibility and necessity of editing and interviewer training in general population surveys. Int J Methods Psychiatr Res 2000;9:32–42.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
Hess D, Gilberg R, Jesske B, Meyer C: Lebensgewohnheiten und Gesundheit in Lübeck und Umgebung. [Habits and Health in Lübeck and its Surrounding Area] Methodenbericht. Bonn, Infas Sozialforschung, 1998.
Robins LN, Wing J, Wittchen HU, Helzer JE, Babor TF, Burke J, Farmer A, Jablenski A, Pickens R, Regier DA: The Composite International Diagnostic Interview: An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 1988;45:1069–1077.
Escobar JI, Burnam MA, Karno M, Forsythe A, Golding JM: Somatization in the community. Arch Gen Psychiatry 1987;44:713–718.
Swartz M, Blazer D, George L, Landerman R: Somatization disorder in a community population. Am J Psychiatry 1986;143:1403–1408.
Porcelli P, De Carne M, Fava GA: Assessing somatization in functional gastrointestinal disorders: Integration of different criteria. Psychother Psychosom 2000;69:198–204.
Porcelli P, De Carne M: Criterion-related validity of the diagnostic criteria for psychosomatic research for alexithymia in patients with functional gastrointestinal disorders. Psychother Psychosom 2001;70:184–188.
Fava GA, Manzelli L, Ruini C: Assessment of psychological distress in the setting of medical disease. Psychother Psychosom 2001;70:171–175.
Schuepbach WM, Adler RH, Sabbioni ME: Accuracy of the clinical diagnosis of ‘psychogenic disorders’ in the presence of physical symptoms suggesting a general medical condition: A 5-year follow-up in 162 patients. Psychother Psychosom 2002;71:11–17.
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