BACKGROUND This study explores the incidence and nature of mental illness among persistent somatisers, and analyses their use of mental health services.
METHOD Individuals with at least ten admissions to non-psychiatric departments during an 8-year period were studied. Persistent somatisers (n = 56) were compared with other frequent users (n = 57) of non-psychiatric services.
RESULTS Of the persistent somatisers, 82% had been examined by a psychiatrist at least once (median, 3 times). Sixteen per cent were mentally retarded, 48% were dependent on alcohol or drugs, and 48% had DSM-III-R personality disorder. The most prevalent ICD-10 diagnoses were anxiety states (54%), depressions (30%), phobias (18%) and psychoses (20%).
CONCLUSIONS Persistent somatisation is associated with severe mental illness and a broad spectrum of heterogeneous psychiatric diagnoses and syndromes. Persistent somatisers impose a serious burden on the mental health care system.