Preliminary Study of Somatic Complaints as Psychiatric Symptoms Based on Cluster Analysis of Symptoms in Modified Enugu Somatization Scale

Background: Patients with somatic complaints in Nigeria have received various psychiatric diagnoses using the yardstick (criteria) originally developed in western cultures. There are concerns about the adequacy of such diagnoses.

Aims: To determine whether or not somatic symptoms occur in clusters that could constitute specific syndromes.

Study Design: The study design was cross sectional.

Place of Study: Psychiatric Clinic of the University of Calabar Teaching Hospital (UCTH), Nigeria.

Methodology: This study included seventy-one patients that were seen at the psychiatric clinic of the UCTH on account of non-organic somatic symptoms. Using the Modified Enugu Somatization Scale (MESS), each participant was requested to subjectively endorse a point on a Visual Analogue Scale (VAS) that best described the severity of each somatic symptom contained in the MESS as it applies to him or her. The participants were also interviewed clinically for possible psychiatric diagnoses based on the criteria of the 10th edition of the International Classification of Diseases (ICD – 10). Their responses on the VAS were subjected to cluster analysis.

Results: Depression, Anxiety and Somatoform disorders were the clinical diagnoses made on the patients. Cluster analysis produced six clusters from which five syndromes were identified. These syndromes were different from one another.

Conclusion: Patients with the same syndrome had different ICD-10 diagnoses indicating that the use of the western illness categories may be inadequate for diagnosing Nigerian patients with somatic complaints.