Gender Differences in the Reporting of Physical and Somatoform Symptoms

OBJECTIVE: Women have consistently been shown to report greater numbers of physical symptoms. Our aim in this study was to assess gender differences for specific symptoms and to assess how much of these differences were attributable to psychiatric comorbidity. METHOD: Data from the PRIME-MD 1000 study (1000 patients from four primary case sites evaluated with the Primary Care Evaluation of Mental Disorders interview) were analyzed to determine gender differences in the reporting of 13 common physical symptoms. The effect of gender on symptom reporting was assessed by multivariate analysis, adjusting for depressive and anxiety disorders as well as age, race, education, and medical comorbidity. RESULTS: All symptoms except one were reported more commonly by women, with the adjusted odds ratios (typically in the 1.5-2.5 range) showing statistically significant differences for 10 of 13 symptoms. Somatoform (ie, physically unexplained) symptoms were also more frequent in women. Although depressive and anxiety disorders were the strongest correlate of symptom reporting, gender had an independent effect that persisted even after adjusting for psychiatric comorbidity. Gender was the most important demographic factor associated with symptom reporting, followed by education. CONCLUSIONS: Most physical symptoms are typically reported at least 50% more often by women than by men. Although mental disorders are also more prevalent in women, gender influences symptom reporting in patients whether or not there is psychiatric comorbidity.