The day‐to‐day concurrence of bodily complaints and affect in patients with severe somatoform disorder

Abstract

Based on the concept of somatization, psychological distress can be experienced as symptoms of physical illness. This suggests a close-fitting intra-individual association between bodily complaints and mood in patients with somatoform disorder (SFD). The contemporaneous day-to-day complaints-mood association was investigated in patients with severe chronic SFD using an ecological momentary assessment (EMA) design. Eleven patients, who had recently received specialized tertiary care treatment for severe chronic SFD, kept an online electronic diary for four consecutive weeks. They were prompted at intervals throughout the day to complete questions on their momentary primary symptoms (pain and fatigue), and mood state (negative and positive). For each measure, day-mean aggregated values were computed and analyzed using linear multilevel (mixed model) regression analysis. Fixed factor results showed that symptoms were associated with both negative mood state (β = 0.47) and positive mood state (β = -0.59). Random results, however, indicated large inter-individual differences, with correlations varying between 0.17 and 0.99 for negative affect, and between -0.88 and 0.14 for positive affect. A substantial day-to-day contemporaneous association between symptoms and affect across subjects, as well as large inter-individual differences in this association, were demonstrated in patients with severe chronic SFD. EMA-data showing the relationship between both negative and (inverse) positive mood and complaints has potential clinical relevance: providing SFD patients with feedback consisting of their personal day-to-day concurrency graph may promote their understanding of their own complaints in a broader context than the somatic area.

Development of a conceptual model for research on cyclical variation of patient reported outcome measurements (PROMs) in patients with chronic conditions: a scoping review

“…The majority of the literature was published from 2000 [ 22 – 42 ], with ten articles published in the last five years [ 22 , 30 , 34 , 35 , 38 , 40 – 45 ]. Seventeen studies were conducted in North America [ 22 , 25 , 27 , 29 , 30 , 33 – 37 , 42 , 45 – 49 ], twelve in Europe [ 23 , 24 , 28 , 31 , 32 , 38 , 40 , 41 , 44 , 50 – 52 ], with two studies across both regions [ 26 , 29 ] and two further studies from Asia [ 43 , 53 ]. Studies were conducted in patients with five broad disease categories: mental health (n = 8) [ 28 , 31 , 35 , 40 – 42 , 46 , 48 ], musculoskeletal (n = 7) [ 23 , 34 , 36 , 39 , 45 , 47 , 54 ], respiratory (n = 5) [ 26 , 27 , 32 , 33 , 51 ], nervous system (n = 4) [ 29 , 36 , 37 , 44 ], and other conditions (n = 8) [ 22 , 25 , 30 , 38 , 43 , 49 , …”

“…Seventeen studies were conducted in North America [ 22 , 25 , 27 , 29 , 30 , 33 – 37 , 42 , 45 – 49 ], twelve in Europe [ 23 , 24 , 28 , 31 , 32 , 38 , 40 , 41 , 44 , 50 – 52 ], with two studies across both regions [ 26 , 29 ] and two further studies from Asia [ 43 , 53 ]. Studies were conducted in patients with five broad disease categories: mental health (n = 8) [ 28 , 31 , 35 , 40 – 42 , 46 , 48 ], musculoskeletal (n = 7) [ 23 , 34 , 36 , 39 , 45 , 47 , 54 ], respiratory (n = 5) [ 26 , 27 , 32 , 33 , 51 ], nervous system (n = 4) [ 29 , 36 , 37 , 44 ], and other conditions (n = 8) [ 22 , 25 , 30 , 38 , 43 , 49 , 50 , 53 ]. Studies sampled mostly adult populations (n = 30), with two studies focusing solely on female adults [ 36 , 49 ], and the remaining focusing on children [ 34 , 39 , 47 ].…”

“…Many of the studies using observational methods used the Ecological Momentary Assessment (EMA) approach to data collection [ 22 , 23 , 25 , 30 , 31 , 36 , 37 , 40 – 42 , 44 – 46 , 53 , 56 , 57 ]. There were two systematic reviews which focused on methodological approaches to collecting real-time data in two specific conditions, depression and COPD [ 28 , 51 ]. The majority of studies used a repeated measures design, collecting data from twice to eight times a day[ 22 , 24 , 25 , 27 , 29 – 31 , 34 , 36 – 39 , 41 , 42 , 44 , 46 , 52 – 56 ], with one study collecting data every three to four months over a 27 month period [ 43 ].…”

“…Furthermore, cold weather has been associated with a breakthrough of chronic prostatitis/chronic pelvic pain syndrome symptoms in the winter compared to acute symptoms reported in the summer [ 43 ]. External rhythms, such as exposure to sunlight or external stimuli, have been linked to variation in outcomes and psychological status with increased sunlight linked to better outcome scores [ 28 , 48 ], and worsening outcomes for long exposure to external stimuli [ 38 ]. Sleep quality was highlighted as a contributing factor to worsening PRO scores due to sleep disruption, triggered by numerous variables such as stress [ 34 , 37 , 49 ] or night-time symptoms [ 51 ] and effects on symptoms such as mood upon awakening, fatigue [ 23 , 44 , 49 ], and poor overall functioning [ 37 ].…”

Treatment course and its predictors in patients with somatoform disorders: A routine outcome monitoring study in secondary psychiatric care

“…Further research on the course of symptoms is important. For instance, Houtveen et al () found substantial fluctuations in bodily complaints and mood states in patients with severe chronic somatoform disorder. Future course studies should preferably assess larger samples, with follow‐up data obtained prospectively, and more frequent interval ratings (Kleinstäuber, Lambert, & Hiller, ).…”