Somatic symptom severity and psychological distress among immigrants: findings from a population-based study

TL;DR

This study finds that second-generation immigrants in Germany report higher somatic symptoms and psychological distress compared to non-immigrants.

Contribution

The study confirms the SSS-8's measurement invariance across immigrant and non-immigrant groups and identifies higher somatic symptom severity in second-generation immigrants.

Findings

The Somatic Symptom Scale-8 (SSS-8) showed measurement invariance across immigrant and non-immigrant groups.

Second-generation immigrants reported higher somatic symptom severity compared to non-immigrants.

Higher somatic symptom severity was associated with younger age, female gender, lower income, and higher psychological distress.

Abstract

Somatic symptoms are frequently reported among immigrants, yet their occurrence and association with psychological distress remain understudied in population-based research using validated and measurement-invariant instruments. This study assessed the measurement invariance of the Somatic Symptom Scale-8 (SSS-8) and compared somatic symptom severity (SSS) between first- and second-generation immigrants and non-immigrants in a German population sample.

Somatic symptom severity and psychological distress were assessed using the SSS-8 and PHQ-4, respectively. Multi-group confirmatory factor analysis was conducted to test the measurement invariance of the SSS-8. Group differences were examined with ANOVA, and hierarchical regression analyses were performed to explore associations between immigration status and SSS, adjusting for distress and sociodemographic variables.

The sample included N = 6860 participants (46.8% women; M = 49.4 years, SD = 18.1), comprising n = 504 first-generation immigrants and n = 472 second-generation immigrants. The SSS-8 demonstrated measurement invariance across groups. Pain was the most frequently reported symptom. High or very high SSS was reported by 9.9% of first-generation immigrants, 12.7% of second-generation immigrants, and 7.5% of non-immigrants. In hierarchical regression models, second-generation immigrant status (ß = .15; 95% CI, 0.08–0.22; p < .001) was associated with greater SSS alongside higher age, female gender, lower income, and distress.

In this study, the SSS-8 demonstrated measurement invariance across immigrant and non-immigrant populations, supporting its applicability for research in diverse sociocultural contexts. The findings suggest a higher vulnerability to SSS and distress among second-generation immigrants, emphasizing the need for targeted screening to improve early identification and healthcare access. However, clinical studies are needed to replicate these findings.

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