Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Functional somatic syndromes: asking about exclusionary medical conditions results in decreased prevalence and overlap rates

Authors: Susanne Fischer, Urs M Nater

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

The diagnosis of functional somatic syndromes (FSS) requires 1) presence of somatic symptoms, and 2) absence of medical conditions potentially accounting for these symptoms. Due to the limited feasibility of medical examinations, epidemiological research on FSS has neglected to assess the second criterion. Our objective was therefore to evaluate the implications of considering information on exclusionary medical conditions in epidemiological research on FSS.

Methods

A survey among 3’054 students was conducted. We compared prevalence rates and overlap of 17 FSS obtained by: 1) a symptom-based strategy and 2) a symptom-and-exclusion-based strategy including information on exclusionary medical conditions.

Results

The symptom-and-exclusion-based strategy led to a marked decrease in prevalence rates compared to the symptom-based strategy. Furthermore, it resulted in fewer individuals who were affected by multiple FSS.

Conclusions

Adding self-reported information on exclusionary medical conditions leads to a significant decrease in the prevalence and overlap of FSS. More rigorous approaches to studying FSS should be adopted.
Appendix
Available only for authorised users
Literature
1.
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A: The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994, 121: 953-959. 10.7326/0003-4819-121-12-199412150-00009.CrossRefPubMed
2.
Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC: Functional bowel disorders. Gastroenterology. 2006, 130: 1480-1491. 10.1053/j.gastro.2005.11.061.CrossRefPubMed
3.
Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, McCain GA, Reynolds WJ, Romano TJ, Russell IJ, Sheon RP: The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990, 33: 160-172. 10.1002/art.1780330203.CrossRefPubMed
4.
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB: The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010, 62: 600-610. 10.1002/acr.20140.CrossRef
5.
Prins JB, van der Meer JWM, Bleijenberg G: Chronic fatigue syndrome. Lancet. 2006, 367: 346-355. 10.1016/S0140-6736(06)68073-2.CrossRefPubMed
6.
Lovell RM, Ford AC: Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012, 10: 712-721 e714. 10.1016/j.cgh.2012.02.029.CrossRefPubMed
7.
McBeth J, Jones K: Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2007, 21: 403-425.CrossRefPubMed
8.
Aaron LA, Buchwald D: A review of the evidence for overlap among unexplained clinical conditions. Ann Intern Med. 2001, 134: 868-881. 10.7326/0003-4819-134-9_Part_2-200105011-00011.CrossRefPubMed
9.
Rodriguez MA, Afari N, Buchwald DS: Evidence for overlap between urological and nonurological unexplained clinical conditions. J Urol. 2009, 182: 2123-2131. 10.1016/j.juro.2009.07.036.CrossRefPubMedPubMedCentral
10.
Wessely S, Nimnuan C, Sharpe M: Functional somatic syndromes: one or many?. Lancet. 1999, 354: 936-939. 10.1016/S0140-6736(98)08320-2.CrossRefPubMed
11.
Wessely S, White PD: There is only one functional somatic syndrome. Br J Psychiatry. 2004, 185: 95-96. 10.1192/bjp.185.2.95.CrossRefPubMed
12.
Warren JW, Clauw DJ: Functional somatic syndromes: sensitivities and specificities of self-reports of physician diagnosis. Psychosom Med. 2012, 74: 891-895. 10.1097/PSY.0b013e31827264aa.CrossRefPubMed
13.
Fischer S, Gaab J, Ehlert U, Nater UM: Prevalence, overlap, and predictors of functional somatic syndromes in a student sample. Int J Behav Med. 2013, 20: 184-193. 10.1007/s12529-012-9266-x.CrossRefPubMed
14.
Nater UM, Fischer S, Latanzio S, Ruoss D, Gaab J: FFSS – Fragebogen zur Erfassung funktioneller somatischer Syndrome [FFSS - Questionnaire on Functional Somatic Syndromes]. Verhaltenstherapie. 2011, 21: 263-265. 10.1159/000333298.CrossRef
15.
IHS: The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004, 24 (Suppl 1): 9-160.
16.
Dworkin SF, LeResche L: Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992, 6: 301-355.PubMed
17.
Galmiche JP, Clouse RE, Balint A, Cook IJ, Kahrilas PJ, Paterson WG, Smout AJ: Functional esophageal disorders. Gastroenterology. 2006, 130: 1459-1465. 10.1053/j.gastro.2005.08.060.CrossRefPubMed
18.
Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, Stanghellini V: Functional gastroduodenal disorders. Gastroenterology. 2006, 130: 1466-1479. 10.1053/j.gastro.2005.11.059.CrossRefPubMed
19.
Bartha L, Baumzweiger W, Buscher DS, Callender T, Dahl KA, Davidoff A, Donnay A, Edelson SB, Elson BD, Elliott E, Flayhan DP, Heuser G, Keyl PM, Kaye H, Gibson P, Jason LA, Krop J, Mazlen RD, McGill RG, McTanney J, Meggs WJ, Morton W, Nass M, Oliver CL, Panjwani DD, Plumlee LA, Rapp D, Shayeviz MB, Sherman J, Singer RM, Solomon A, Vodjani A, Woods JM, Ziem G: Multiple chemical sensitivity: a 1999 consensus. Arch Environ Health. 1999, 54: 147-149.CrossRef
20.
Nickel JC, Nyberg LM, Hennenfent M: Research guidelines for chronic prostatitis: consensus report from the first National Institutes of Health International Prostatitis Collaborative Network. Urology. 1999, 54: 229-233. 10.1016/S0090-4295(99)00205-8.CrossRefPubMed
21.
WHO: The ICD-10 Classification of Mental and Behavioural Disorders - Clinical Descriptions and Diagnostic Guidelines. 1992, Geneva: World Health Organization
22.
APA: Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision). 2000, Washington D.C: Author
23.
van Dixhoorn J, Duivenvoorden HJ: Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. J Psychosom Res. 1985, 29: 199-206. 10.1016/0022-3999(85)90042-X.CrossRefPubMed
24.
Reyes M, Nisenbaum R, Hoaglin DC, Unger ER, Emmons C, Randall B, Stewart JA, Abbey S, Jones JF, Gantz N, Minden S, Reeves WC: Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas. Arch Intern Med. 2003, 163: 1530-1536. 10.1001/archinte.163.13.1530.CrossRefPubMed
25.
Perrot S, Vicaut E, Servant D, Ravaud P: Prevalence of fibromyalgia in France: a multi-step study research combining national screening and clinical confirmation: The DEFI study (Determination of Epidemiology of FIbromyalgia). BMC Musculoskelet Disord. 2011, 12: 224-10.1186/1471-2474-12-224.CrossRefPubMedPubMedCentral
26.
Koloski NA, Talley NJ, Boyce PM: Epidemiology and health care seeking in the functional GI disorders: a population-based study. Am J Gastroenterol. 2002, 97: 2290-2299. 10.1111/j.1572-0241.2002.05783.x.CrossRefPubMed
27.
Schur EA, Afari N, Furberg H, Olarte M, Goldberg J, Sullivan PF, Buchwald D: Feeling bad in more ways than one: comorbidity patterns of medically unexplained and psychiatric conditions. J Gen Intern Med. 2007, 22: 818-821. 10.1007/s11606-007-0140-5.CrossRefPubMedPubMedCentral
28.
Aggarwal VR, McBeth J, Zakrzewska JM, Lunt M, Macfarlane GJ: The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors?. Int J Epidemiol. 2006, 35: 468-476.CrossRefPubMed
29.
Dansie EJ, Furberg H, Afari N, Buchwald D, Edwards K, Goldberg J, Schur E, Sullivan PF: Conditions comorbid with chronic fatigue in a population-based sample. Psychosomatics. 2012, 53: 44-50. 10.1016/j.psym.2011.04.001.CrossRefPubMed
30.
Kato K, Sullivan PF, Pedersen NL: Latent class analysis of functional somatic symptoms in a population-based sample of twins. J Psychosom Res. 2010, 68: 447-453. 10.1016/j.jpsychores.2010.01.010.CrossRefPubMedPubMedCentral
31.
Fink P, Schroder A: One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. J Psychosom Res. 2010, 68: 415-426. 10.1016/j.jpsychores.2010.02.004.CrossRefPubMed
32.
Rosmalen JG, Tak LM, de Jonge P: Empirical foundations for the diagnosis of somatization: implications for DSM-5. Psychol Med. 2011, 41: 1133-1142. 10.1017/S0033291710001625.CrossRefPubMed
Metadata
Title
Functional somatic syndromes: asking about exclusionary medical conditions results in decreased prevalence and overlap rates
Authors
Susanne Fischer
Urs M Nater
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-1034

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue

Research article

Changes in family income status and the development of overweight and obesity from 2 to 15 years: a longitudinal study

Research article

Knowledge and perceptions of brucellosis in the pastoral communities adjacent to Lake Mburo National Park, Uganda

Research article

From the parents’ perspective: a user-satisfaction survey of immunization services in Guatemala

Research article

Risk behaviors and sports facilities do not explain socioeconomic differences in childhood obesity: a cross-sectional study

Research article

Contribution of respiratory tract infections to child deaths: a data linkage study

Research article

Can gender difference in prescription drug use be explained by gender-related morbidity?: a study on a Swedish population during 2006