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The epidemiology of multiple somatic symptoms

The epidemiology of multiple somatic symptoms
The epidemiology of multiple somatic symptoms

Background: the risk factors for a high total somatic symptom count are unclear; and it is not known whether total somatic symptoms count is a predictor of impaired health status. Method: A prospective population-based cohort study in North West England. Randomly sampled residents (1443 participants; 58% response) completed questionnaires to determine number of somatic symptoms (SSI), health status and a wide range of risk factors; 741 completed questionnaires 1. year later. We used logistic regression to identify risk factors for high SSI at follow-up and for persistently high SSI. We used ANCOVAR and multiple regression to assess whether baseline SSI predicted health status at follow-up. 

Results: twenty-one percent of participants scored over 25 on the Somatic Symptom Inventory (SSI) at baseline and 14% at both baseline and follow-up. Risk factors for a persistent high SSI were: fewer than 12. years of education, separated, widowed or divorced status, reported psychological abuse during childhood, co-existing medical illnesses, anxiety and depression. In multivariate analysis baseline SSI predicted health status (SF12 physical component score and health-related quality of life (EuroQol)) 12. months later. Persistent high SSI was a clinically meaningful predictor of these outcomes. 

Conclusions: our data support a biopsychosocial approach to somatic symptoms rather than the dualistic approach of identifying "medically unexplained" symptoms. The risk factors for total somatic symptom count were those associated with psychiatric disorders including physical illness. A persistent high somatic symptom count provides a readily measured dimension of importance in epidemiology as a predictor of health status.

Epidemiology, Health-related quality of life, Somatisation, Somatoform disorders
0022-3999
311-317
Creed, Francis H.
5b34349d-b1e1-4fe4-8393-974101a9808e
Davies, Ian
fa56a127-4521-400c-a970-ca89b01c244d
Jackson, Judy
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Littlewood, Alison
3742b2be-5f6b-460c-8e55-546d0b0faffb
Chew-Graham, Carolyn
0b6e770e-73fe-46ed-b477-c304a5019956
Tomenson, Barbara
6304e030-da3c-4d46-a93a-eec5448f1609
Macfarlane, Gary
e17bbdb7-9d82-42ac-8a0a-09bf10885e3c
Barsky, Arthur
04eb483c-8761-4bfb-adbf-e3a922042324
Katon, Wayne
0aeeb241-8aa2-4fde-bd92-3a919b87cc2e
McBeth, John
98012716-66ba-480b-9e43-ac53b51dce61
Creed, Francis H.
5b34349d-b1e1-4fe4-8393-974101a9808e
Davies, Ian
fa56a127-4521-400c-a970-ca89b01c244d
Jackson, Judy
e8be4ed8-5e42-4418-bff5-3dcc38959745
Littlewood, Alison
3742b2be-5f6b-460c-8e55-546d0b0faffb
Chew-Graham, Carolyn
0b6e770e-73fe-46ed-b477-c304a5019956
Tomenson, Barbara
6304e030-da3c-4d46-a93a-eec5448f1609
Macfarlane, Gary
e17bbdb7-9d82-42ac-8a0a-09bf10885e3c
Barsky, Arthur
04eb483c-8761-4bfb-adbf-e3a922042324
Katon, Wayne
0aeeb241-8aa2-4fde-bd92-3a919b87cc2e
McBeth, John
98012716-66ba-480b-9e43-ac53b51dce61

Creed, Francis H., Davies, Ian, Jackson, Judy, Littlewood, Alison, Chew-Graham, Carolyn, Tomenson, Barbara, Macfarlane, Gary, Barsky, Arthur, Katon, Wayne and McBeth, John (2012) The epidemiology of multiple somatic symptoms. Journal of Psychosomatic Research, 72 (4), 311-317. (doi:10.1016/j.jpsychores.2012.01.009).

Record type: Article

Abstract

Background: the risk factors for a high total somatic symptom count are unclear; and it is not known whether total somatic symptoms count is a predictor of impaired health status. Method: A prospective population-based cohort study in North West England. Randomly sampled residents (1443 participants; 58% response) completed questionnaires to determine number of somatic symptoms (SSI), health status and a wide range of risk factors; 741 completed questionnaires 1. year later. We used logistic regression to identify risk factors for high SSI at follow-up and for persistently high SSI. We used ANCOVAR and multiple regression to assess whether baseline SSI predicted health status at follow-up. 

Results: twenty-one percent of participants scored over 25 on the Somatic Symptom Inventory (SSI) at baseline and 14% at both baseline and follow-up. Risk factors for a persistent high SSI were: fewer than 12. years of education, separated, widowed or divorced status, reported psychological abuse during childhood, co-existing medical illnesses, anxiety and depression. In multivariate analysis baseline SSI predicted health status (SF12 physical component score and health-related quality of life (EuroQol)) 12. months later. Persistent high SSI was a clinically meaningful predictor of these outcomes. 

Conclusions: our data support a biopsychosocial approach to somatic symptoms rather than the dualistic approach of identifying "medically unexplained" symptoms. The risk factors for total somatic symptom count were those associated with psychiatric disorders including physical illness. A persistent high somatic symptom count provides a readily measured dimension of importance in epidemiology as a predictor of health status.

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More information

Accepted/In Press date: 12 January 2012
e-pub ahead of print date: 2 February 2012
Published date: April 2012
Keywords: Epidemiology, Health-related quality of life, Somatisation, Somatoform disorders

Identifiers

Local EPrints ID: 492273
URI: http://eprints.soton.ac.uk/id/eprint/492273
ISSN: 0022-3999
PURE UUID: b97fea7c-9cf3-4852-9f89-72ff261388b4
ORCID for John McBeth: ORCID iD orcid.org/0000-0001-7047-2183

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Date deposited: 23 Jul 2024 16:41
Last modified: 24 Jul 2024 02:11

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Contributors

Author: Francis H. Creed
Author: Ian Davies
Author: Judy Jackson
Author: Alison Littlewood
Author: Carolyn Chew-Graham
Author: Barbara Tomenson
Author: Gary Macfarlane
Author: Arthur Barsky
Author: Wayne Katon
Author: John McBeth ORCID iD

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