Somatic Symptom Patterns in Mood and Psychotic Disorders: A Focus on Race and Gender

Somatic symptoms, including fatigue, unexplained body aches, and weakness, are common in psychiatric populations but may be experienced and reported differently across demographic groups. This study examined race and gender differences in somatic symptom presentation among individuals with major depressive disorder, schizophrenia, and healthy controls. Analyses controlled for chronic medical burden to better isolate psychological symptom patterns. Women reported significantly more fatigue and physical symptoms than men. However, no gender differences emerged when assessing anxiety-related somatic symptoms. This suggests that gender disparities in reporting may depend on the type and framing of symptoms assessed. For race, Black participants reported significantly higher fatigue and were rated by clinicians as having higher somatic concern, though only after controlling for chronic illness. Importantly, no race or gender differences were found on a cognitive fatigue subscale, suggesting these effects were specific to physical manifestations of distress. These findings underscore how somatic symptoms are measured, both in terms of item content and symptom domain, may shape whose distress is recognized and how it is interpreted in psychiatric settings.