Skip to main content
SpringerLink
Log in

Predictors of a Functional Somatic Syndrome Diagnosis in Patients with Persistent Functional Somatic Symptoms

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Functional somatic syndromes (FSS) are characterized by the existence of multiple persistent functional somatic symptoms. Not many patients fulfilling the criteria for an FSS, receive a formal diagnosis, and it is unknown which factors explain this discrepancy. Patients that tend to worry and patients that gather more health information may have an increased chance of an FSS diagnosis. We hypothesized that high intelligence and high neuroticism increase the probability of an FSS diagnosis in patients with persistent functional somatic symptoms.

Purpose

This study aims to investigate patient factors that might be important in the process of syndrome labeling.

Methods

Our study was performed in a large, representative population cohort (n = 976) in Groningen, The Netherlands, and included two assessment waves. Intelligence was measured using the General Aptitude Test Battery version B 1002-B. Neuroticism was measured using the 12-item neuroticism scale of the Eysenck Personality Questionnaire-Revised. Functional somatic symptoms were measured with the somatization section of the Composite International Diagnostic Interview. Current FSS diagnosis was assessed with a questionnaire. We performed multivariable logistic regression analyses including sum scores of neuroticism, intelligence scores, sex, number of functional somatic symptoms, and age as potential predictors of having an FSS diagnosis.

Results

From the 976 participants that completed measurements at follow-up, 289 (26.4 %) participants reported at least one persistent functional somatic symptom, and these subjects were included in the main analyses (38.4 % males, mean age of 55.2 years (SD = 10.7), 36–82 years). High numbers of functional somatic symptoms ((OR) = 1.320; 95 % (CI) = 1.097–1.588), female sex (OR = 9.068; 95 % CI = 4.061–20.251), and high intelligence (OR = 1.402; 95 % CI = 1.001–1.963) were associated with an FSS diagnosis, while age (OR = 0.989; 95 % CI = 960–1.019) and neuroticism (OR = 0.956; 95 % CI = 0.872–1.048) were not.

Conclusion

This study suggests that high intelligence, but not high neuroticism, increases the chance of syndrome labeling in patients with persistent functional somatic symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mayou R, Farmer A. ABC of psychological medicine: Functional somatic symptoms and syndromes. Br Med J. 2002;325(7358):265–8.

    Article  Google Scholar 

  2. Mayou R. Somatization. Psychother Psychosom. 1993;59(2):69–83.

    Article  PubMed  CAS  Google Scholar 

  3. Solomon L, Reeves WC. Factors influencing the diagnosis of chronic fatigue syndrome. Arch Intern Med. 2004;164(20):2241–5.

    Article  PubMed  Google Scholar 

  4. Huibers MJH, Wessely S. The act of diagnosis: Pros and cons of labelling chronic fatigue syndrome. Psychol Med. 2006;36(7):895–900.

    Article  PubMed  Google Scholar 

  5. Kanaan RA, Lepine JP, Wessely SC. The association or otherwise of the functional somatic syndromes. Psychosom Med. 2007;69(9):855–9.

    Article  PubMed  Google Scholar 

  6. Goubert L, Crombez G, Van Damme S. The role of neuroticism, pain catastrophizing and pain-related fear in vigilance to pain: A structural equations approach. Pain. 2004;107(3):234–41.

    Article  PubMed  Google Scholar 

  7. Cotten SR, Gupta SS. Characteristics of online and offline health information seekers and factors that discriminate between them. Soc Sci Med. 2004;59(9):1795–806.

    Article  PubMed  Google Scholar 

  8. Willems S, De Maesschalck S, Deveugele M, Derese A, De Maeseneer J. Socio-economic status of the patient and doctor-patient communication: Does it make a difference? Patient Educ Couns. 2005;56(2):139–46.

    Article  PubMed  CAS  Google Scholar 

  9. Smith R. In search of “non-disease”. Br Med J. 2002;324(7342):883–5.

    Article  Google Scholar 

  10. Buitenhuis J, de Jong PJ, Jaspers JP, Groothoff JW. Catastrophizing and causal beliefs in whiplash. Spine (Phila Pa 1976). 2008;33(22):2427–33. discussion 2434.

    Article  CAS  Google Scholar 

  11. Pinto-Sietsma SJ, Janssen WMT, Hillege HL, Navis G, De Zeeuw D, de Jong PE. Urinary albumin excretion is associated with renal functional abnormalities in a nondiabetic population. J Am Soc Nephrol. 2000;11(10):1882–8.

    PubMed  CAS  Google Scholar 

  12. Sanderman R, Eysenck SBG, Arrindell WA. Cross-cultural comparisons of personality: The Netherlands and England. Psychol Rep. 1991;69(3):1091–6.

    Article  Google Scholar 

  13. Bosch F, Boomsma-Suerink JL. Manual Generalized Aptitude Test Battery. 1981.

  14. Rosmalen JGM, Neeleman J, Gans ROB, de Jonge P. The association between neuroticism and self-reported common somatic symptoms in a population cohort. J Psychosom Res. 2007;62(3):305–11.

    Article  PubMed  Google Scholar 

  15. Wessely S, Nimnuan C, Sharpe M. Functional somatic syndromes: One or many? Lancet. 1999;354(9182):936–9.

    Article  PubMed  CAS  Google Scholar 

  16. Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, et al. Scientific monograph of the Quebec Task Force on whiplash-associated disorders: Redefining whiplash and its management. Spine. 1995;20(8):S1–73.

    Google Scholar 

  17. Andrews G, Peters L. The psychometric properties of the composite international diagnostic interview. Soc Psychiatry Psychiatr Epidemiol. 1998;33(2):80–8.

    Article  PubMed  CAS  Google Scholar 

  18. Costa Jr PT, McCrae RR. Neuroticism, somatic complaints, and disease: is the bark worse than the bite? J Pers. 1987;55(2):299–316.

    Article  PubMed  Google Scholar 

  19. Kingma EM, Tak LM, Huisman M, Rosmalen JGM. Intelligence is negatively associated with the number of functional somatic symptoms. J Epidemiol Community Health. 2009;63(11):900–U54.

    Article  PubMed  CAS  Google Scholar 

  20. Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes. Lancet. 2007;369(9565):946–55.

    Article  PubMed  Google Scholar 

  21. Rosmalen JGM. The way forward: A case for longitudinal population-based studies in the field of functional somatic syndromes. J Psychosom Res. 2010;68(5):399–401.

    Article  PubMed  Google Scholar 

  22. Kingma EM, Janssens KAM, Venema M, Ormel J, de Jonge P, Rosmalen JGM. Adolescents with low intelligence are at risk of functional somatic symptoms: The TRAILS study. J Adolesc Health. 2011;49(6):621–6.

    Article  PubMed  Google Scholar 

  23. Salmon P. Patients who present physical symptoms in the absence of physical pathology: A challenge to existing models of doctor-patient interaction. Patient Educ Couns. 2000;39(1):105–13.

    Article  PubMed  CAS  Google Scholar 

  24. Risor MB. Illness explanations among patients with medically unexplained symptoms: Different idioms for different contexts. Health. 2009;13(5):505–21.

    PubMed  Google Scholar 

  25. Thompson WG, Heaton KW, Smyth GT, Smyth C. Irritable bowel syndrome in general practice: prevalence, characteristics, and referral. Gut. 2000;46(1):78–82.

    Article  PubMed  CAS  Google Scholar 

  26. Barsky AJ, Peekna HM, Borus JF. Somatic symptom reporting in women and men. Journal of General Internal Medicine. 2001;16(4):266–75.

    Article  PubMed  CAS  Google Scholar 

  27. Hamilton WT, Gallagher AM, Thomas JM, White PD. The prognosis of different fatigue diagnostic labels: A longitudinal survey. Fam Pract. 2005;22(4):383–8.

    Article  PubMed  Google Scholar 

  28. Vickers MH. Stigma, work and “unseen” illness: A case and notes to enhance understanding. Ilness, Crisis and Loss. 2000;8(2):131–51.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700, RB, Groningen, The Netherlands

    Eva M. Kingma, Peter de Jonge, Johan Ormel & Judith G. M. Rosmalen

Authors
  1. Eva M. Kingma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter de Jonge
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johan Ormel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Judith G. M. Rosmalen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Judith G. M. Rosmalen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kingma, E.M., de Jonge, P., Ormel, J. et al. Predictors of a Functional Somatic Syndrome Diagnosis in Patients with Persistent Functional Somatic Symptoms. Int.J. Behav. Med. 20, 206–212 (2013). https://doi.org/10.1007/s12529-012-9251-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-012-9251-4

Keywords

Search

Navigation