Schovsbo Signe U, Dantoft Thomas M, Thuesen Betina H, Leth-Møller Katja B, Eplov Lene F, Petersen Marie W, Jørgensen Torben, Osler Merete
Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region of Denmark, Denmark.
Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Denmark.
Scand J Public Health. 2023 Mar;51(2):225-232. doi: 10.1177/14034948211056752. Epub 2021 Nov 19.
It is generally accepted that functional somatic disorders (FSDs) are a product of biological, psychological, and social factors. Social position might be part of this complex, but the literature on this issue is currently heterogeneous and inconsistent. The aim of the present study was - in a population-based cohort - to test the hypothesis that lower social position would be associated with higher a risk of FSD.
The association between social position and FSD was examined in a cross-sectional study with various measures of social position (education as measured by vocational training; employment; cohabitation; subjective social status) and delimitations of FSD (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, bodily distress syndrome, and symptom profiles). The associations were analyzed using logistic regressions to calculate odds ratios and 95% confidence intervals. Each social measure was analyzed independently and was adjusted for age and sex.
Lower levels of vocational training, being unemployed, and living alone were associated with higher risk of FSD, regardless of the FSD delimitation. There was also a significant negative association between subjective evaluated social status and FSD. The associations remained after multiple adjustments, and seemed to be strongest for the more severe FSD-types.
Lower social position is associated with higher risk of FSD, especially the more severe FSD delimitations, which might constitute an especially vulnerable group. However, the mechanisms behind the relations remain unknown.
人们普遍认为，功能性躯体障碍（FSDs）是生物、心理和社会因素共同作用的结果。社会地位可能是这一复杂因素的一部分，但目前关于这一问题的文献参差不齐且相互矛盾。本研究的目的是，在一个基于人群的队列中，检验社会地位较低会增加患FSD风险这一假设。
在一项横断面研究中，通过多种社会地位衡量指标（以职业培训衡量的教育程度、就业情况、同居情况、主观社会地位）和FSD的界定范围（肠易激综合征、慢性疲劳综合征、纤维肌痛、身体不适综合征和症状概况），研究社会地位与FSD之间的关联。使用逻辑回归分析这些关联，以计算比值比和95%置信区间。对每个社会指标进行独立分析，并对年龄和性别进行校正。
无论FSD的界定范围如何，职业培训水平较低、失业和独居都与患FSD的较高风险相关。主观评估的社会地位与FSD之间也存在显著的负相关。经过多次校正后，这些关联仍然存在，并且对于更严重的FSD类型似乎最为明显。
社会地位较低与患FSD的较高风险相关，尤其是更严重的FSD界定范围，这可能构成一个特别脆弱的群体。然而，两者之间关系背后的机制仍然未知。
