Associations of somatic symptom attribution in Turkish patients with major depression
Sammanfattning
Background: There are differences across ethno-cultural groups in the degree of somatization among
patients with major depressive disorder (MDD). Studies showed that the attribution style of somatic
symptoms is an important predictor of health outcome in depressed patients. Aims: The aims of this
study were to investigate associations of psychologizing, normalizing and somatizing attribution
styles as measured by the Symptom Interpretation Questionnaire (SIQ) in Turkish patients with MDD.
Methods: Ninety patients who were diagnosed with a major depressive episode using a semi-
structured interview were administered the SIQ to assess attribution styles, each of which was
regressed on age, gender, educational level, depressive symptom severity, tendency for
somatosensory amplification, current somatic symptoms and alexithymia. Results: Scores on
somatizing, psychologizing and normalizing attribution subscales of the SIQ were strongly correlated
with each other. Somatosensory amplification and alexithymia were independent correlates of
somatizing attributions. Higher levels of psychologizing and normalizing attributions were both
related to more severe symptoms of depression and to somatosensory amplification. Conclusions:
These results suggested that patients with higher levels of depressive symptoms were more likely to
engage in a greater diversity of attribution styles as measured by the SIQ in our sample. Independent
correlates of somatic symptom attribution in patients with MDD were found to be different from
Western countries, suggestive of disparate cultural characteristics and help-seeking pathways and
behaviour in Turkey.