Petersen Marie Weinreich, Carstensen Tina Birgitte Wisbech, Frostholm Lisbeth, Wellnitz Kaare Bro, Ørnbøl Eva, Jørgensen Torben, Eplov Lene Falgaard, Dantoft Thomas Meinertz, Fink Per
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark.
Clin Epidemiol. 2023 Mar 27;15:407-419. doi: 10.2147/CLEP.S399914. eCollection 2023.
Several psychological factors have been proposed to be associated with functional somatic disorders (FSD) including functional somatic syndromes, such as irritable bowel, chronic widespread pain, and chronic fatigue. However, large randomly selected population-based studies of this association are sparse. This study aimed to investigate the association between FSD and perceived stress and self-efficacy, respectively, and to investigate if FSD differed from severe physical diseases on these aspects.
This cross-sectional study included a random sample of the adult Danish population (n = 9656). FSD were established using self-reported questionnaires and diagnostic interviews. Perceived stress was measured with Cohen's Perceived Stress Scale and self-efficacy with the General Self-Efficacy Scale. Data were analysed with generalized linear models and linear regression models.
FSD were associated with higher perceived stress and lower self-efficacy, especially for the multi-organ and the general symptoms/fatigue FSD types and for chronic fatigue. However, controlling for the personality trait neuroticism altered the associations with self-efficacy so it became insignificant. The analysis did not support an important interaction between perceived stress and self-efficacy on the likelihood of having FSD. Individuals with FSD presented levels of perceived stress that were not equal, ie higher, to those in individuals with severe physical diseases.
FSD were positively associated with perceived stress and negatively associated with self-efficacy. Our study may point to stress being part of the symptomatology of FSD. This underlines the severity of having FSD and stresses the relevance of the resilience theory in the understanding of the condition.
已提出多种心理因素与功能性躯体障碍（FSD）相关，包括功能性躯体综合征，如肠易激综合征、慢性广泛性疼痛和慢性疲劳。然而，针对这种关联的大型随机抽样人群研究却很稀少。本研究旨在分别调查FSD与感知压力和自我效能之间的关联，并调查FSD在这些方面是否与严重躯体疾病有所不同。
这项横断面研究纳入了丹麦成年人群的随机样本（n = 9656）。通过自我报告问卷和诊断访谈来确定FSD。使用科恩感知压力量表测量感知压力，使用一般自我效能量表测量自我效能。数据采用广义线性模型和线性回归模型进行分析。
FSD与较高的感知压力和较低的自我效能相关，尤其是对于多器官型和一般症状/疲劳型FSD以及慢性疲劳。然而，控制人格特质神经质后，与自我效能的关联发生了变化，变得不显著。分析不支持感知压力和自我效能对患FSD可能性的重要交互作用。患有FSD的个体所呈现的感知压力水平与患有严重躯体疾病的个体并不相同，即更高。
FSD与感知压力呈正相关，与自我效能呈负相关。我们的研究可能表明压力是FSD症状学的一部分。这凸显了患有FSD的严重性，并强调了复原力理论在理解该病症中的相关性。
