Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Psychosomatics. 2020 May-Jun;61(3):268-276. doi: 10.1016/j.psym.2020.01.012. Epub 2020 Feb 10.
Somatic symptom disorder (SSD) is characterized by a persistent and distressing psychological reaction to somatic symptoms. In pain disorders, the preoccupation with physical symptoms is associated with poor long-term outcomes. SSD may therefore be of use to identify and help chronic pain patients with particular needs.
To test the hypothesis that in fibromyalgia, SSD is associated with higher anxiety sensitivity, health anxiety, and reactivity to pain, in addition to lower nonreactivity to inner experiences. In addition, to investigate if individuals with SSD report a larger impact of fibromyalgia core symptoms, more somatic symptoms, and higher psychiatric comorbidity.
Using data from a clinical trial involving self-referred individuals with fibromyalgia, we compared participants with SSD to participants without SSD using t-tests and logistic regression.
Forty-nine out of 140 participants (35%) had SSD. Most findings corroborate that individuals with fibromyalgia who also meet criteria for SSD are worse off in terms of traits previously found to be predictive of a poor course in pain disorders. Post hoc analyses indicated that this could not be explained merely by a higher level of fibromyalgia core symptoms.
SSD appears to be associated with a higher symptom burden in fibromyalgia, but further research is needed to draw firm conclusions regarding the reliability, acceptability, and utility of the SSD diagnosis in the clinic.
躯体症状障碍（SSD）的特征是对躯体症状持续存在且令人痛苦的心理反应。在疼痛障碍中，对身体症状的过分关注与较差的长期预后相关。因此，SSD 可能有助于识别和帮助有特殊需求的慢性疼痛患者。
检验假设，即 SSD 与更高的焦虑敏感、健康焦虑和对疼痛的反应性相关，而与对内在体验的低反应性相关，此外还检验 SSD 患者是否报告了更大的纤维肌痛核心症状、更多的躯体症状和更高的精神共病的假设。
使用一项涉及自我报告的纤维肌痛患者的临床试验数据，我们使用 t 检验和逻辑回归比较了 SSD 患者和非 SSD 患者。
140 名参与者中有 49 名（35%）患有 SSD。大多数研究结果证实，患有纤维肌痛且符合 SSD 标准的患者在先前发现与疼痛障碍不良预后相关的特征方面表现更差。事后分析表明，这不能仅仅用更高水平的纤维肌痛核心症状来解释。
SSD 似乎与纤维肌痛的更高的症状负担相关，但需要进一步研究以就 SSD 诊断在临床中的可靠性、可接受性和实用性得出明确结论。
