Multiple Somatic Symptoms Predict Impaired Health Status in Functional Somatic Syndromes

  • F. H. Creed
  • B. Tomenson
  • C. Chew-Graham
  • G. J. Macfarlane
  • I. Davies
  • J. Jackson
  • A. Littlewood
  • J. McBeth
Article
First Online:

Abstract

Background

The relationship between functional somatic syndromes and multiple somatic symptoms is unclear.

Purpose

We assessed whether the number of somatic symptoms is a predictor of health status in three functional somatic syndromes (FSS).

Methods

In a population-based study of 990 UK adults we assessed chronic widespread pain (CWP), chronic fatigue (CF) and irritable bowel syndrome (IBS) by questionnaire and medical record data. We assessed health status (Short Form 12 and EQ-5D), number of somatic symptoms (Somatic Symptom Inventory) and anxiety/depression (Hospital Anxiety and Depression Scale) both at baseline and at follow-up 1 year later.

Results

The proportion of people with an FSS who also have multiple somatic symptoms (52–55 %) was similar in the three functional syndromes. The presence of multiple somatic symptoms was associated with more impaired health status both at baseline and at follow-up. This finding was not explained by severity of FSS. In the absence of multiple somatic symptoms, the health status of the FSS was fair or good. In multiple regression analysis, the number of somatic symptoms, the presence of a functional syndrome (CWP or CF) and anxiety/depression were predictors of EQ-5D thermometer at follow-up after adjustment for confounders.

Conclusions

Multiple somatic symptoms in people with an FSS are associated with impaired health status and this cannot be explained by more severe functional syndrome or the presence of anxiety and depression.

Keywords

Somatisation Functional somatic syndromes Health status Chronic widespread pain Irritable bowel syndrome Chronic fatigue 

Abbreviations

CWP

Chronic widespread pain

CF

Chronic fatigue

IBS

Irritable bowel syndrome

SF-12

Short Form 12

EQ-5D

EURQOL

SSI

Somatic Symptoms Inventory

HADS

Hospital Anxiety and Depression Scale

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Notes

Acknowledgements

We are grateful to the participants in the project and to the General Practitioners who facilitated it. The study was funded by the UK Medical Research Council. The UK MRC had no role in study design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Conflicts of interest

None.

Author contributions

All authors had full access to all the data in the study, have been involved in drafting and/or revising the article critically and given final approval of the version to be published. The corresponding author takes responsibility for the integrity of the data and the accuracy of the data analysis

C. Chew-Graham, F. Creed, G. Macfarlane, J. McBeth: Study development, design, data collection, data analysis, manuscript preparation and revision.

I. Davies, J. Jackson, A. Littlewood: Data collection and analysis, manuscript preparation and revision.

B. Tomenson: Data analysis, manuscript preparation and revision.

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Copyright information

© International Society of Behavioral Medicine 2012

Authors and Affiliations

  • F. H. Creed
    • 1
  • B. Tomenson
    • 1
  • C. Chew-Graham
    • 2
  • G. J. Macfarlane
    • 3
  • I. Davies
    • 4
  • J. Jackson
    • 1
  • A. Littlewood
    • 4
  • J. McBeth
    • 4
  1. 1.School of Community Based MedicineUniversity of ManchesterManchesterUK
  2. 2.School of Community-Based Medicine, Health Sciences–Primary care Research GroupUniversity of ManchesterManchesterUK
  3. 3.Aberdeen Pain Research Collaboration (Epidemiology Group)University of AberdeenAberdeenUK
  4. 4.Arthritis Research UK Epidemiology UnitUniversity of ManchesterManchesterUK

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