Systematic review on somatization in a transcultural context among teenagers and young adults: Focus on the nosography blur

Abstract

AimsSomatic complaints are a frequent cause for consultation in primary care. In a transcultural context, somatic complaints are typically associated with psychological distress. A recent review about somatic symptom disorders in adolescence showed some nosographic heterogeneity and outlined various etiological hypotheses (traumatic, environmental, or neurologic), separate from the cross-cultural considerations. Migrants' children encounter specific problems involving cultural mixing-issues of filiation (familial transmission) and affiliation (belonging to a group). This paper aims to provide a systematic review of somatization in transcultural contexts among teenagers and young adults, aged 13 to 24, over the past decade.MethodsThis review adheres to the quality criteria set forth by the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two authors queried three English databases (Medline, PsycInfo, WebOfScience) about somatization in transcultural contexts (migrant or non-Western population) among teenagers (13–18), young adults (19–24), or both. The methodological process comprised articles selection, data extraction, and then the analysis of emerging themes. Setting selection criteria to limit the transcultural field was difficult.ResultsThe study analyzed 68 articles. We present a descriptive analysis of the results, centered on three main themes. First, the literature highlights a nosographic muddle reflected in the combination of anxious and depressive symptoms together with the highly variable symptomatology. Second, discrimination issues were prevalent among the migrant population. Lastly, the literature review points out possibilities for improving a care pathway and reducing the diagnostic delay induced by migrants' hesitancy about Western care and the recurrent use of inappropriate diagnostic criteria.ConclusionThis review discusses the links between the nosographic muddle described here and the diagnostic delays these patients experience and raises concerns about rigid diagnostic compartmentalization. The work of the psychiatrist Frantz Fanon is here useful to understand externalized symptoms resulting from physical and psychological confinement. Discrimination issues raise questions about the cultural counter-transference health professionals experience in dealing with young migrants. Defining healthcare professionals' representations about somatic complaints in a transcultural context might be a fruitful path to explore in future research.Protocol PROSPERO registration numberCRD42021294132. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021294132.

Correlations between somatic symptoms and resilience among a group of Vietnamese : Lessons learned from Covid 19

“…Yet, expressing suffering and soma symptoms can vary depending on culture . In some cultures that stigmatize mental health problems, psychological symptoms are expressed in the form of physical complaints such as insomnia, fatigue, chest pain, or heart pain [14]. In the context of COVID-19 crisis, with its suddenness beyond human expectations, has increased not only anxiety disorders, depression, and suicidal thoughts, but also increased somatoform disorders.…”

“…Moreover, mental illness carries a great stigma in Vietnamese culture, and thus individuals will tend to somaticize their problems and report only the physical symptoms or less significant elements [5]. It has been reported that symptoms of tiredness or fatigue, loss of sleep, heart issues, stomachache were found in the survivors of COVID-19 epidemic and there would be 15 symptoms that the human body can reveal when faced with stressful experiences, specifically: 1) stomach pain; 2) back pain; 3) pain in arms, legs, and joints; 4) menstrual disorders, dysmenorrhea (for women); 5) headache; 6) chest pain; 7) dizziness/lightheadedness; 8) fainting; 9) heart palpitations; 10) difficulty breathing ; 11) difficulties in sex life; 12) constipation or diarrhea; 13) nausea, belching, indigestion; 14) fatigue, lack of strength; 15) difficulty sleeping (CDC, 2021; DSM-V). Researchers also stated that long COVID-19 syndrome shares similarities with somatic syndromes characterized by persistent somatic symptoms of unclear etiology [6].…”