From the, University of Manchester, Manchester, United Kingdom.
Psychosom Med. 2022;84(9):1056-1066. doi: 10.1097/PSY.0000000000001101. Epub 2022 Jul 7.
Multiple bodily symptoms predict poor health status, high healthcare use, and onset of functional somatic syndromes. This study aimed to identify the predictors of somatic symptoms with special reference to mental disorders.
The prospective, population-based Lifelines cohort study included 80,888 adults who were followed up for a mean of 2.4 years. At baseline sociodemographic status, self-reported medical disorders, functional somatic syndromes, stress, neuroticism, mental disorders (assessed with Mini-International Neuropsychiatric Interview), health perception, and analgesic use were assessed. These variables were tested as predictors of number of somatic symptoms at follow-up using linear regression analysis, which adjusted for baseline somatic symptoms ( n = 65,904). Logistic regression was used to identify the predictors of a persistently high number of somatic symptoms.
The strongest predictors of somatic symptoms at follow-up were life events and difficulties score, and number of general medical illnesses/functional somatic syndromes. Neuroticism and mental disorders were also independent predictors in all analyses. Generalized anxiety, major depressive, and panic disorders were all independent predictors when entered individually into the regression analysis. A persistently high number of somatic symptoms were predicted most strongly by functional somatic syndromes, negative health perception, and paracetamol use.
Number of somatic symptoms should be regarded as a multifactorial measure with many predictors. Mental disorders form one predictor, but there are other stronger ones, including stress and general medical disorders. The bidirectional relationship between functional somatic syndromes and multiple somatic symptoms is compatible with the notion that perception of bodily symptoms is a key component of both.
多种躯体症状预示着健康状况不佳、医疗保健使用率高和功能性躯体综合征的发生。本研究旨在确定躯体症状的预测因素，特别是与精神障碍有关的预测因素。
前瞻性、基于人群的莱夫斯生活研究（Lifelines）纳入了 80888 名成年人，平均随访时间为 2.4 年。在基线时评估了社会人口统计学状况、自我报告的医学疾病、功能性躯体综合征、压力、神经质、精神障碍（采用 Mini-国际神经精神访谈进行评估）、健康感知和止痛药使用情况。使用线性回归分析，对这些变量进行随访时躯体症状数量的预测因素进行测试，该分析调整了基线躯体症状（n=65904）。使用逻辑回归来确定持续存在大量躯体症状的预测因素。
随访时躯体症状的最强预测因素是生活事件和困难评分，以及一般医学疾病/功能性躯体综合征的数量。神经质和精神障碍在所有分析中也是独立的预测因素。当单独纳入回归分析时，广泛性焦虑症、重度抑郁症和恐慌症都是独立的预测因素。持续存在大量躯体症状最强的预测因素是功能性躯体综合征、负面健康感知和扑热息痛使用。
躯体症状的数量应被视为具有多种预测因素的多因素衡量指标。精神障碍是一个预测因素，但还有其他更强的因素，包括压力和一般医学疾病。功能性躯体综合征和多种躯体症状之间的双向关系与躯体症状感知是两者的关键组成部分的概念是一致的。
