Total somatic symptom score as a predictor of health outcome in somatic symptom disorders

Barbara Tomenson , Cecilia Essau , Frank Jacobi , Karl Heinz Ladwig , Kari Ann Leiknes , Roselind Lieb , Gunther Meinlschmidt , John McBeth , Judith Rosmalen , Winfried Rief , Athula Sumathipala , Francis Creed , EURASMUS Population Based Study Group
  • Declaration of interest

    F.C. has been a member of the American Psychiatric Association DSM-5 work group on somatic distress disorders and he and A.S. are members of the World Health Organization ICD-11 working group on the classification of somatic distress and dissociative disorders.

Abstract

Background

The diagnosis of somatisation disorder in DSM-IV was based on ‘medically unexplained’ symptoms, which is unsatisfactory.

Aims

To determine the value of a total somatic symptom score as a predictor of health status and healthcare use after adjustment for anxiety, depression and general medical illness.

Method

Data from nine population-based studies (total n = 28 377) were analysed.

Results

In all cross-sectional analyses total somatic symptom score was associated with health status and healthcare use after adjustment for confounders. In two prospective studies total somatic symptom score predicted subsequent health status. This association appeared stronger than that for medically unexplained symptoms.

Conclusions

Total somatic symptom score provides a predictor of health status and healthcare use over and above the effects of anxiety, depression and general medical illnesses.

Footnotes

  • Funding

    The American Psychiatric Association funded this study. The original studies, whose data have been used in this paper were funded by: German Federal Ministry of Research, Education and Science, BMBF, Deutsche Forschungsgemeinschaft (DFG), Netherlands Organisation for Scientific Research (NOW), Norwegian Research Council, UK Medical Research Council.

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