Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
Institute of Health Behaviors and Community Sciences and Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
J Formos Med Assoc. 2022 Sep;121(9):1813-1822. doi: 10.1016/j.jfma.2022.03.009. Epub 2022 Mar 30.
Functional somatic syndromes (such as chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome) are often comorbid. Whether these syndromes are distinct constructs and whether they have different psychological features are interesting questions. We perform a cluster analysis based on a nationwide survey in Taiwan to answer these questions.
A score of at least 5 on the Patient Health Questionnaire-15 (PHQ-15, measuring somatic symptoms) indicated somatic syndromes and the data of 550 subjects were included. According to the gastrointestinal, pain-fatigue and cardiovascular subdimension scores of the PHQ-15, we performed a two-step cluster analysis. The demographic data and the cluster scores of the Health Anxiety Questionnaire and the Patient Health Questionnaire-4 (measuring depression and anxiety) were compared. Multinomial logistic and multiple linear regression analyses were used to clarify the associations between clusters/somatic symptoms and demographics/psychological features.
Four clusters were generated and named according to their somatic features: "high gastrointestinal symptoms", "high pain-fatigue and comorbid somatic symptoms", "middle to high pain-fatigue symptoms" and "high cardiovascular symptoms". The high pain-fatigue and comorbid somatic symptom cluster had the highest levels of extent to which symptoms interfere with a person's life, depression and anxiety. The high cardiovascular symptom cluster was featured by high excessive worry over health and illness and low educational level. The high gastrointestinal symptom cluster had relatively low psychopathologies.
The results of this population-based analysis supported the existence of distinct somatic syndromes that are not parts of a single whole somatic syndrome and have different psychological features.
功能性躯体综合征（如慢性疲劳综合征、纤维肌痛、肠易激综合征）常合并存在。这些综合征是否为不同的构建体，以及它们是否具有不同的心理特征，是一个有趣的问题。我们基于台湾的一项全国性调查进行聚类分析，以回答这些问题。
PHQ-15（测量躯体症状）得分至少为 5 分表明存在躯体综合征，共纳入 550 名受试者的数据。根据 PHQ-15 的胃肠道、疼痛疲劳和心血管子维度评分，我们进行了两步聚类分析。比较健康焦虑问卷和 PHQ-4（测量抑郁和焦虑）的人口统计学数据和聚类得分。使用多项逻辑回归和多元线性回归分析来阐明聚类/躯体症状与人口统计学/心理特征之间的关系。
根据躯体特征生成了四个聚类，并分别命名为：“高胃肠道症状”、“高疼痛疲劳和合并躯体症状”、“中至高疼痛疲劳症状”和“高心血管症状”。高疼痛疲劳和合并躯体症状聚类的症状对生活干扰程度、抑郁和焦虑程度最高。高心血管症状聚类的特点是对健康和疾病的过度担忧程度较高，文化程度较低。高胃肠道症状聚类的心理病理程度相对较低。
这项基于人群的分析结果支持存在不同的躯体综合征，它们不是单一整体躯体综合征的一部分，并且具有不同的心理特征。
