Unemployment and Anxiety Explain Somatoform Pain Disorder in Trauma-Exposed Patients with Immigrant Background
1
University of Oslo, Oslo, Norway
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Somatoform Pain Disorder (SPD) is a chronic debilitating condition without a clear biomedical explanation. The association between SPD and trauma is well-documented. SPD has also been observed more frequently in non-Western immigrants compared to native population in Western countries. However, there is limited understanding of the factors that explain this difference in a clinical population. This study examines how socio-demographic factors and psychiatric disorders explain the association between migration status and SPD in trauma-exposed patient population in Norway.
METHODS:
A cross-sectional study was conducted in 110 trauma-exposed patient population, comprising 44 native Norwegians and 66 Immigrants, attending secondary mental health outpatient clinic in Southern Oslo, Norway. Standardized tools were used to explore SPD and psychiatric disorders while self-reported questionnaires were used to collect information on traumatic events, migration status, and socioeconomic characteristics. Bayesian logistic regression models were applied to determine the association between migration status and somatoform pain disorder in these patient population. The relationships of these measures were also assessed through regression-based mediation and moderation analysis.
RESULTS:
SPD prevalence was significantly higher among patients with immigrant background (44%) than native Norwegians patients (20%). Mediation analysis indicated that unemployment partially accounted for the association between migration status and SPD (24%). Additionally, anxiety moderated the relationship, increasing SPD risk in the immigrant group. Other psychiatric disorders, such as PTSD and depression, were common in both groups but did not significantly alter the main associations.
CONCLUSIONS:
The higher prevalence of SPD in trauma-exposed immigrant patients may be partly attributed to higher rates of unemployment and the effects of anxiety disorders. The findings highlight the need for targeted interventions that address both the socioeconomic and psychological determinants of SPD. Integrated treatment that addresses unemployment and anxiety could be a key to lower the SPD burden in this vulnerable population.
Somatoform Pain Disorder (SPD) is a chronic debilitating condition without a clear biomedical explanation. The association between SPD and trauma is well-documented. SPD has also been observed more frequently in non-Western immigrants compared to native population in Western countries. However, there is limited understanding of the factors that explain this difference in a clinical population. This study examines how socio-demographic factors and psychiatric disorders explain the association between migration status and SPD in trauma-exposed patient population in Norway.
METHODS:
A cross-sectional study was conducted in 110 trauma-exposed patient population, comprising 44 native Norwegians and 66 Immigrants, attending secondary mental health outpatient clinic in Southern Oslo, Norway. Standardized tools were used to explore SPD and psychiatric disorders while self-reported questionnaires were used to collect information on traumatic events, migration status, and socioeconomic characteristics. Bayesian logistic regression models were applied to determine the association between migration status and somatoform pain disorder in these patient population. The relationships of these measures were also assessed through regression-based mediation and moderation analysis.
RESULTS:
SPD prevalence was significantly higher among patients with immigrant background (44%) than native Norwegians patients (20%). Mediation analysis indicated that unemployment partially accounted for the association between migration status and SPD (24%). Additionally, anxiety moderated the relationship, increasing SPD risk in the immigrant group. Other psychiatric disorders, such as PTSD and depression, were common in both groups but did not significantly alter the main associations.
CONCLUSIONS:
The higher prevalence of SPD in trauma-exposed immigrant patients may be partly attributed to higher rates of unemployment and the effects of anxiety disorders. The findings highlight the need for targeted interventions that address both the socioeconomic and psychological determinants of SPD. Integrated treatment that addresses unemployment and anxiety could be a key to lower the SPD burden in this vulnerable population.
| eISSN: | 2654-1459 |
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