The unifying diagnostic construct of bodily distress syndrome (BDS) was confirmed in the general population

Petersen, Marie Weinreich; Schröder, Andreas; Jørgensen, Torben; Ørnbøl, Eva; Dantoft, Thomas Meinertz; Eliasen, Marie; Thuesen, Betina Heinsbæk; Fink, Per

doi:10.1016/j.jpsychores.2019.109868

Cited by 48 publications

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“…By encompassing a range of FSS, it presents a new way of defining and delimitating these syndromes taking into account the overlaps between FSS [30][31][32] . The BDS diagnostic construct has recently been verified in a sample from the general Danish population 33 , but until now, only one study about the epidemiology of BDS in a general population-based sample (n = 9656) has been conducted 34 , and further studies on BDS are needed.…”

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Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

Petersen

Schröder

Jørgensen

et al. 2020

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prevalence of functional somatic syndromes (fSS) in the general population varies with observed overlap between syndromes. However, studies including a range of fSS are sparse. We investigated prevalence and characteristics of various fSS and the unifying diagnostic construct bodily distress syndrome (BDS), and identified mutual overlap of the FSS and their overlap with BDS. We included a stratified subsample of 1590 adults from a randomly selected Danish general population sample (n = 7493). Telephonic diagnostic interviews performed by three trained physicians were used to identify individuals with FSS and BDS. Prevalence of overall FSS was 9.3%; 3.8% for irritable bowel, 2.2% for chronic widespread pain, 6.1% for chronic fatigue, 1.5% for whiplash associated disorders, and 0.9% for multiple chemical sensitivity. Prevalence of BDS was 10.7% where 2.0% had the multi-organ type. fSS were highly overlapping with low likelihood of having a "pure" type. Diagnostic agreement of FSS and BDS was 92.0%. Multi-syndromatic FSS and multi-organ BDS were associated with female sex, poor health, physical limitations, and comorbidity. fSS are highly prevalent and overlapping, and multi-syndromatic cases are most affected. BDS captured the majority of FSS and may improve clinical management, making the distinction between multi-and mono-syndromatic patients easier. Functional somatic syndromes (FSS), such as irritable bowel syndrome (IBS), fibromyalgia/chronic widespread pain (FM/CWP), chronic fatigue syndrome (CFS), whiplash associated disorders (WAD), and multiple chemical sensitivity (MCS), are prevalent in various medical settings and cause great impairment in patients and high health care costs for society. A variety of other terms are used in the literature for these syndromes, central sensitization syndromes 1 and medically unexplained symptoms 2 among others, which underlines the very different conceptualization of these health conditions in current medicine. However, regardless the clinician's a-priori conceptualisation, the present lack of objective clinical signs or reproducible paraclinical findings constitutes a diagnostic challenge as the diagnoses in clinical practise rely on subjective symptom reports, exclusion of relevant differential diagnoses, and the medical history 3-9. Reviews on IBS, FM, and CFS have shown varying prevalence in general populations: 1-45% for IBS 6,10-13 , 0.5-9% for FM 5,14-16 , and 0.1-2.8% for CFS 17-20. One population-based study has found a prevalence of WAD of 1.4-2.9% 21. For MCS, reviews of population-based prevalence also vary tremendously: One review presented prevalence of physician-diagnosed MCS of 0.5% reviews while another have reported a prevalence of MCS of between 1 and 15% 22,23. The considerable variation in prevalence may be attributed to the different diagnostic criteria used for each FSS. Furthermore, a substantial overlap of symptoms between various FSS diagnoses has been shown, indicating

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Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

Petersen

Schröder

Jørgensen

et al. 2020

Sci Rep

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“…Häuser and his German colleagues found substantial overlap between somatic symptom disorder, bodily distress syndrome, and fibromyalgia in a representative sample in Germany [8]. This overlap lends support to the proposed unifying construct of functional somatic disorder [9,10]. We have recently published a Research Interview for Functional Somatic Disorders that may be useful for assessment of these conditions in research and would be feasible for use even in large, population-based https://doi.org/10.1016/j.jpsychores.2020.110123…”

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confidence: 71%

“…T studies [11]. The journal has a proud tradition of being at the forefront of disseminating research that shapes the psychiatric nosology of these conditions [10,[12][13][14][15][16][17][18][19].…”

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New challenges in the COVID-19 pandemic

Fiedorowicz

2020

Journal of Psychosomatic Research

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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“…[15][16][17] However, the existing questionnaires measure PPS without considering the well-known aggregation of such symptoms into symptom clusters, and hence without acknowledgement of the real structure of PPS as they occur in both the community and in clinical setting. [18][19][20][21] When PPS occur in the absence of (other) physical or mental conditions, or when they cause individual suffering and functional…”

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The BDS checklist as measure of illness severity: a cross-sectional cohort study in the Danish general population, primary care and specialised setting

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ObjectiveThe bodily distress syndrome (BDS) checklist has proven to be useful in the diagnostic categorisation and as screening tool for functional somatic disorders (FSD). This study aims to investigate whether the BDS checklist total sum score (0–100) can be used as a measure of physical symptom burden and FSD illness severity.DesignCross-sectional.SettingDanish general population, primary care and specialised clinical setting.ParticipantsA general population cohort (n=9656), a primary care cohort (n=2480) and a cohort of patients with multiorgan BDS from specialised clinical setting (n=492).Outcome measuresAll data were self-reported. Physical symptoms were measured with the 25-item BDS checklist. Overall self-perceived health was measured with one item from the 36-item Short-Form Health Survey (SF-36). Physical functioning was measured with an aggregate score of four items from the SF-36/SF-12 scales ‘physical functioning’, ‘bodily pain’ and ‘vitality’. Emotional distress was measured with the mental distress subscale (SCL-8) from the Danish version of the Hopkins Symptom Checklist-90. Illness worry was measured with the six-item Whiteley Index.ResultsFor all cohorts, bifactor models established that despite some multidimensionality the total sum score of the BDS checklist adequately reflected physical symptom burden and illness severity. The BDS checklist had acceptable convergent validity with measures of overall health (r=0.25–0.58), physical functioning (r=0.22–0.58), emotional distress (r=0.47–0.62) and illness worry (r=0.36–0.55). Acceptability was good with a low number of missing responses to items (<3%). Internal consistency was high (α ≥0.879). BDS score means varied and reflected symptom burden across cohorts (13.03–46.15). We provide normative data for the Danish general population.ConclusionsThe BDS checklist total sum score can be used as a measure of symptom burden and FSD illness severity across settings. These findings establish the usefulness of the BDS checklist in clinics and in research, both as a diagnostic screening tool and as an instrument to assess illness severity.

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The unifying diagnostic construct of bodily distress syndrome (BDS) was confirmed in the general population

Cited by 48 publications

References 41 publications

Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

New challenges in the COVID-19 pandemic

The BDS checklist as measure of illness severity: a cross-sectional cohort study in the Danish general population, primary care and specialised setting

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