Predictors of Persistent Medically Unexplained Physical Symptoms: Findings From a General Population Study

Sluijs, Jonna van Eck van F. der; Have, Margreet ten; Graaf, Ron de; Rijnders, C.A.Th.; Marwijk, Harm van; Feltz-Cornelis, Christina M. van der

doi:10.3389/fpsyt.2018.00613

Cited by 20 publications

(13 citation statements)

References 69 publications

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“…Higher education, higher levels of physical functioning, and higher emotional wellbeing at baseline are associated with low, stable symptom severity. This is in line with previous research that suggests that these factors have a positive influence on overall functioning and wellbeing (van Eck van der Sluijs et al, 2018). Here, we also found that the lower one rates his or her own general health, the lower the odds that one has persisting common somatic symptoms.…”

Section: Predictors Of Stable and Increasing Common Somatic Symptomssupporting

confidence: 93%

Female sex and femininity independently associate with common somatic symptom trajectories

et al. 2020

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Background Multiple predictors have been associated with persistent somatic symptoms. However, previous studies problematically defined the persistence of symptoms, conflated participants' sex and gender, and focused on patient populations. Therefore, we studied associations between predictors, especially sex and gender, and longitudinal patterns of somatic symptoms in the general adult population. We also assessed whether predictors for persisting symptoms differ between sexes. Method To identify developmental trajectories of somatic symptoms, assessed by the SCL-90 SOM, we used latent class trajectory modeling in the Dutch Lifelines Cohort Study [N = 150 494; 58.6% female; median time to follow-up: 46.0 (min–max: 22.0–123.0) months]. To identify predictors of trajectories, we applied multiple logistic regression analyses. Predictors were measured by surveys at baseline and a composite gender index was previously developed. Results A five-class linear LCGA model fitted the data best: 93.7% of the population had a stable symptom trajectory, whereas 1.5% and 4.8% of the population had a consistently increasing or decreasing symptom trajectory, respectively. Female sex predicted severe, stable symptom severity (OR 1.74, 95% CI 1.36–2.22), but not increasing symptom severity (OR 1.15, 95% CI 0.99–1.40). Femininity was protective hereof (OR 0.60, 95% CI 0.44–0.82 and OR 0.66, 95% CI 0.51–0.85, respectively). Merely a few predictors of symptom severity, for instance hours of paid employment and physical functioning, differed in strength between sexes. Yet, effect sizes were small. Conclusion Female sex and femininity predict symptom trajectories. No large sex differences in the strength of additional predictors were found, thus it may not be clinically useful to distinguish between predictors specific to male or female patients of persistent somatic symptoms.

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Section: Predictors Of Stable and Increasing Common Somatic Symptomssupporting

confidence: 93%

Female sex and femininity independently associate with common somatic symptom trajectories

et al. 2020

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“…Many studies examined the association between SSD and the presence of chronic disease. They revealed a strong association, increasing in strength, with an increasing number of chronic diseases diagnosed in a single person [ 20 , 27 ]. For example, a large population-based study found a strong association between heart attacks and the history of major surgeries and SSD [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Somatic symptom disorders and utilization of health services among Palestinian primary health care attendees: a cross-sectional study

Nazzal

Maraqa

Zant

et al. 2021

BMC Health Serv Res

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Background Many primary health care (PHC) clients come in with medically unexplained complaints, leading to frequent consultations and high usage of services and healthcare costs. This study aimed to determine the prevalence of somatic symptom disorder (SSD) among PHC attendees and explore its relation to other mental conditions and risk factors. Methods A cross-sectional design was used to interview 400 attendees. Men and women aged over 18 years old without a psychiatric diagnosis were invited to participate. The Somatization scale of the Four-Dimensional Symptom Questionnaire was used to assess somatic symptom disorders. It is a valid tool to be used in a PHC setting. We used the Chi-square test and multivariable logistic regression to explore determinant variables. Results Prevalence of SSD was 32.5% (95%CI = 27.9–37.1%). The most common symptoms were painful muscles (61.5%) followed by back pain (52.3%). Female gender [adjusted OR = 2.1 (95% CI = 1.2–3.7)], chronic diseases [adjusted OR = 2.4 (95%CI = 1.3–4.5)], depression [adjusted OR = 3.3 (95%CI = 2.0–5.5)], and anxiety [adjusted OR = 2.1 (95%CI = 1.2–3.6)] were all associated with SSD. In addition, frequent primary health care attendance was found to be associated with SSD [adjusted OR = 2.4 (95%CI = 1.4–4.1)]. Conclusions SSD significantly higher among females, patients with chronic diseases, clients with anxiety and depressive disorders, and patients with frequent doctors’ visits. Painful muscles and back pain are the most common symptom presented by patients, and this could be used initially by PHC physicians as a signal to consider for screening.

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“… 31 Different from the previous construct somatoform disorders, the concept “medically unexplained“ has been removed in SSD; therefore, SSD may co-exist in patients with medical comorbidity. 32 , 33 SSD-12 has been found to effectively diagnose SSD in a population with medical comorbidity. 31 Third, though diagnosing SSD is not the strength of CABAH, its abundant cognitive measurements may still have clinical values.…”

Section: Discussionmentioning

confidence: 99%

Psychometric Properties of the Chinese Version of the Cognitions About Body and Health Questionnaire

Liao

Huang

2021

NDT

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Introduction The Cognitions About Body and Health Questionnaire (CABAH) is a self-rating questionnaire measuring cognitions about health. The psychometric properties of its Chinese version and its performance on evaluating somatic symptom disorder (SSD) were examined in this study. Methods After translating the CABAH into Chinese, we collected data of the CABAH and another four questionnaires (Patient Health Questionnaire-15, Health Anxiety Questionnaire, Beck Depression Inventory-II, Beck Anxiety Inventory) in 208 SSD patients and 197 healthy individuals. We used exploratory factor analysis (EFA) to explore the structure of the Chinese CABAH. Internal consistency and criterion-related validity were analyzed. An independent t -test and receiver operating characteristic (ROC) curve analysis were used to evaluate the performance of the CABAH for evaluating SSD. Results Six factors were suggested by EFA. Five (bodily weakness, health habits, catastrophizing interpretation of specific bodily complaints, somatosensory amplification, catastrophizing interpretation of general bodily complaints) are conceptually associated with the original CABAH. The sixth factor (reverse, with three items) is different from the original construct. Cronbach’s alpha for the CABAH was 0.885. The CABAH score was moderately correlated with scores of the other four questionnaires. Scores for the whole CABAH and scores of the six factors were all significantly higher in SSD patients than in healthy individuals. The results of ROC curve analysis were as follows: area under the curve=0.700; suggested cutoff=58/59; Youden’s J =0.295. Conclusion The reliability and validity of the Chinese CABAH were fair, although the three items in the reverse factor should be interpreted cautiously.

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Predictors of Persistent Medically Unexplained Physical Symptoms: Findings From a General Population Study

Cited by 20 publications

References 69 publications

Female sex and femininity independently associate with common somatic symptom trajectories

Female sex and femininity independently associate with common somatic symptom trajectories

Somatic symptom disorders and utilization of health services among Palestinian primary health care attendees: a cross-sectional study

Psychometric Properties of the Chinese Version of the Cognitions About Body and Health Questionnaire

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