Within somatization, unexplained neurological symptoms (UNSs) have been shown to mark a distinct subgroup with greater clinical severity. However, some UNSs resemble ataque de nervios somatic symptoms. This raises questions about cultural factors related to Hispanics with somatization characterized by UNSs. To examine cultural factors, preliminary analyses examined the relationship between Hispanic ethnicity, UNSs, and ataque de nervios. Data were obtained from 127 primary care patients (95 Hispanic, 32 European American) with somatization. The Composite International Diagnostic Interview provided somatization data, whereas the Primary Care Evaluation of Mental Disorders was used for data on Axis I disorders. Ataque de nervios was assessed via a proxy measure. Within each ethnic group, cross-tabs examined the relationship between ataque de nervios and multiple UNSs, and ataque de nervios and selected Axis I disorders. Only among Hispanics, a significant overlap was found between ataque de nervios and having four or more UNSs (p < .001), and ataque de nervios and a diagnosis of panic disorder (p = .05). Although equal percentages of European Americans and Hispanics experience multiple UNSs, these results show that the presentation of UNSs among some Hispanics may be qualitatively different, because it may involve features related to ataque de nervios. A diagnosis of panic disorder also appears to interact with cultural factors.
*Department of Psychiatry, UMDNJ, Robert Wood Johnson Medical School, Piscataway, New Jersey; †Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey; and ‡Department of Family Medicine, UMDNJ, Robert Wood Johnson Medical School, Piscataway, New Jersey.
Supported in part by a grant from the National Institute of Mental Health (grant no. R01 MH 60265) and funding from University Behavioral Healthcare.
Send reprint requests to Alejandro Interian, PhD, UMDNJ, Robert Wood Johnson Medical School, Department of Psychiatry, 675 Hoes Lane, D306, Piscataway, NJ 08854.