Department of Psychology, Leiden University, Leiden, the Netherlands.
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.
J Psychosom Res. 2021 Dec;151:110655. doi: 10.1016/j.jpsychores.2021.110655. Epub 2021 Oct 29.
Stress may augment somatic symptoms in central sensitivity syndromes (CSS) such as fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. To test this hypothesis, we examined whether the association between COVID-19 stress and somatic symptom severity would be stronger in people with than without CSS and whether psychological flexibility would buffer the impact of this stress on symptom severity.
In a 2-sample, repeated cross-sectional design, we analysed questionnaire data from Dutch people with and without CSS, collected in two independent surveys: before the COVID-19 pandemic (2018; CSS: n = 194, non-CSS: n = 337) and at the peak of the pandemic (2020; CSS: n = 428, non-CSS: n = 1101). Somatic symptom severity, worry and stress due to the pandemic, and psychological flexibility were examined in regression analyses. Two stress operationalisations were analysed: stress levels during the peak of the pandemic, and a comparison of measurements in 2020 and 2018 (assuming higher stress levels in 2020).
Higher worry and stress during the pandemic (standardized β = 0.14), the presence of a CSS (β = 0.40), and lower psychological flexibility (β = -0.33) were all (p < .0001) associated with more severe somatic symptoms, but the associations of each stress operationalisation with somatic symptoms was not particularly strong in people with CSS (β = -0.026, p = .27; β = -0.037, p = .22), and psychological flexibility (β = -0.025, p = .18; β = 0.076, p = .35) did not buffer this association.
Findings do not support the hypotheses that COVID-19 stress augments somatic symptoms, particularly in CSS, or that psychological flexibility buffers this impact. Rather, COVID-19-related stress appears to have an uncertain impact on somatic symptoms.
压力可能会加剧中枢敏化综合征（CSS）中的躯体症状，例如纤维肌痛、慢性疲劳综合征和肠易激综合征。为了验证这一假设，我们检测了 COVID-19 压力与躯体症状严重程度之间的关联在 CSS 患者中是否强于无 CSS 患者，以及心理灵活性是否会缓冲这种压力对症状严重程度的影响。
在 2 个样本、重复的横截面设计中，我们分析了荷兰有和无 CSS 的人群的问卷调查数据，这些数据是在两次独立的调查中收集的：COVID-19 大流行之前（2018 年；CSS：n=194，非 CSS：n=337）和大流行高峰期（2020 年；CSS：n=428，非 CSS：n=1101）。我们在回归分析中检查了躯体症状严重程度、对大流行的担忧和压力，以及心理灵活性。分析了两种压力操作化：大流行高峰期的压力水平，以及 2020 年和 2018 年的测量值比较（假设 2020 年的压力水平更高）。
更高的担忧和大流行期间的压力（标准化β=0.14）、存在 CSS（β=0.40）和较低的心理灵活性（β=-0.33）均与更严重的躯体症状相关（均 p<0.0001），但每种压力操作化与躯体症状的关联在 CSS 患者中并不特别强（β=-0.026，p=0.27；β=-0.037，p=0.22），心理灵活性（β=-0.025，p=0.18；β=0.076，p=0.35）也没有缓冲这种关联。
研究结果不支持 COVID-19 压力加剧躯体症状，尤其是在 CSS 患者中的假设，也不支持心理灵活性缓冲这种影响的假设。相反，与 COVID-19 相关的压力对躯体症状的影响似乎不确定。
