Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark; Department of Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark; Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark.
J Psychosom Res. 2022 Dec;163:111064. doi: 10.1016/j.jpsychores.2022.111064. Epub 2022 Oct 18.
Bodily Distress Syndrome (BDS) represents a new research concept for adult patients with various functional somatic syndromes. We evaluated the utility of the BDS research concept and the associated BDS-25-checklist as a screening tool for diverse functional somatic symptoms (FSS) in adolescence by investigating: 1) the psychometric and factorial structures of the checklist, 2) symptom cluster patterns and 3) illness classification and associations with emotional psychopathology and sociodemographic factors.
This cross-sectional study obtained data from the 16/17-year follow-up (N = 2542) of the general population Copenhagen Child Cohort 2000 (CCC2000). We used self-reported questionnaires to assess physical symptoms (the BDS-25 checklist), overall health (KidScreen), emotional psychopathology (Spence Children's Anxiety Scale; The Mood and Feelings Questionnaire), and illness worry (Whiteley-6 Index), and utilized data from Danish national registers to assess sociodemographic factors.
The BDS-25 checklist items displayed satisfactory psychometric data quality. Factor analyses revealed a similar four-factor model as reported in adults (factor loadings λ ≥0.5), representing distinct BDS symptom clusters: cardio-pulmonary, gastro-intestinal, musculoskeletal and general symptoms. Latent class analyses revealed a model with three latent classes, i.e. probable no to mild BDS, probable moderate, single-organ BDS and probable severe, multi-organ BDS, displaying acceptable class quality (Entropy = 0.904). Trend analyses revealed sociodemographic group differences across latent classes. Increased emotional psychopathology was associated with more pronounced BDS symptoms.
Our findings support the BDS concept with four symptom clusters and three illness severity groups (no BDS, single- organ and multi-organ BDS) to screen for FSS in adolescence.
身体痛苦综合征（BDS）是一种针对各种功能性躯体综合征成年患者的新研究概念。我们通过调查以下内容来评估 BDS 研究概念及其相关的 BDS-25 检查表作为青少年各种功能性躯体症状（FSS）筛查工具的效用：1）检查表的心理计量学和因子结构，2）症状聚类模式，以及 3）疾病分类以及与情绪心理病理学和社会人口因素的关联。
本横断面研究从一般人群哥本哈根儿童队列 2000 年（CCC2000）的 16/17 岁随访（N=2542）中获取数据。我们使用自我报告问卷评估身体症状（BDS-25 检查表）、总体健康（KidScreen）、情绪心理病理学（Spence 儿童焦虑量表；心境和感觉问卷）和疾病担忧（Whiteley-6 指数），并利用丹麦国家登记册的数据评估社会人口因素。
BDS-25 检查表项目显示出令人满意的心理计量学数据质量。因子分析显示出与成人报告相似的四因子模型（因子负荷λ≥0.5），代表不同的 BDS 症状聚类：心肺、胃肠、肌肉骨骼和一般症状。潜在类别分析显示出具有三个潜在类别的模型，即可能无到轻度 BDS、可能中度、单一器官 BDS 和可能严重、多器官 BDS，具有可接受的类别质量（熵=0.904）。趋势分析显示出潜在类别之间的社会人口群体差异。情绪心理病理学增加与更明显的 BDS 症状相关。
我们的研究结果支持 BDS 概念，具有四个症状聚类和三个疾病严重程度组（无 BDS、单一器官和多器官 BDS），用于筛查青少年的 FSS。
