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American Journal of Epidemiology Vol. 136, No. 1: 95-105
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Relations over Time between Psychiatric and Somatic Disorders: The Stirling County Study

Jane M. Murphy1,2,3,, Richard R. Monson3, Donald C. Olivier4, Gwendolyn E. P. Zahner3, Arthur M. Sobol1 and Alexander H. Leighton5

1Psychiatric Epidemiology Unit, Psychiatry Service, Massachusetts General Hospital Boston, MA
2Department of Psychiatry, Harvard Medical School Boston, MA
3Department of Epidemiology, Harvard School of Public Health Boston, MA
4Instructional Computing Facility, Harvard School of Public Health Boston, MA
5Department of Psychiatry and Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University Halifax, Nova Scotia, Canada

Reprint requests to Dr. Jane M. Murphy, 705 Warren Building, Massachusetts General Hospital, Fruit Street, Boston, MA 02114.

A longitudinal study of a general population in Atlantic Canada provided information on associations between two broad categories of illness: somatic disorders and disorders involving depression and/or anxiety. Prevalence was investigated in a sample of 1, 003 adults selected in 1952 and another sample of 1, 094 adults selected in 1970. Using a cohort of 618 survivors from the 1952 sample who were followed up in 1968, the authors studied prevalence at the beginning and end of the 16-year period. Incidence was also investigated so that the strength of associations between prior illness of one type and subsequent illness of the other type could be assessed. Data were obtained by interviewing subjects with the same structured schedule at each time of investigation. In prevalence enumerations, psychiatric disorders were found to be significantly associated with somatic disorders. Prior somatic disorder was significantly associated with subsequent incidence of depression and/or anxiety and vice versa. The results did not, however, show one direction of influence ("psyche-to-soma" or "soma-to-psyche") to be markedly stronger than the other. The results mainly support the concept of "generalized vulnerability" and draw attention to the importance of recognizing comorbidity in diagnosis and clinical practice.

anxiety; comorbidity; depression; holistic health; psychiatry


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