Explanation of somatic symptoms by mental health and personality traits: application of Bayesian regularized quantile regression in a large population study

Shayan Mostafaei,Kourosh Kabir,Saeed Masoud Arzaghi,Saeid Rasekhi Dehkordi,Peyman Adibi,Fataneh Ghadirian,Marjan Mansourian,Anoshirvan Kazemnejad,Awat Feizi,Hamid Afshar,Ammar Hassanzadeh Keshteli

doi:10.1186/s12888-019-2189-1

Abstract

BackgroundSomatic syndrome is one of the remarkably prevalent issues in primary health care and subspecialty settings. We aimed to elucidate multidimensional associations between somatic symptoms with major mental problems and personality traits in the framework of the quantile regression model with a Bayesian approach.MethodsA total of 4763 employees at Isfahan University of Medical Sciences and Health Services in Isfahan province, Iran, filled out four validated questionnaires including Hospital Anxiety and Depression Scale (HADS), NEO Questionnaire, General Health Questionnaire (GHQ) and PHQ-15 for somatic symptom severity. In addition, Functional Gastrointestinal Disorders (FGIDs) were determined using Rome IV criteria. Exploratory Factor Analysis (EFA) and Bayesian regularized quantile regression with adaptive LASSO penalization were applied for reduced dimension of somatic symptoms and variable selection and parameter estimation, respectively.ResultsThe 25 major somatic symptoms were grouped into four factors including general, upper gastrointestinal, lower gastrointestinal and respiratory by EFA. Stress, depression, and anxiety had significant effects on all of the four extracted factors. The effect of anxiety in each four extracted factors was more than stress and depression. Neuroticism and agreeableness had significant effects on all of the four extracted factors, generally (p < 0.05).ConclusionsGiven the high prevalence of somatic symptoms and psychosomatic complaints in correlation with the diverse range of mental co-morbidities, developing more detailed diagnostic tools and methods is crucial; nonetheless, it seems that providing better interdisciplinary approaches in general medical practice is groundwork.

Highlights

Somatic syndrome is one of the remarkably prevalent issues in primary health care and subspecialty settings
Somatization symptoms factors After Exploratory Factor Analysis (EFA), four factors were extracted from 25 somatization symptoms
Given high prevalence of somatic symptoms and psychosomatic complaints in correlation with diverse range of mental co-morbidities, developing more detailed diagnostic tools and methods is crucial; it seems that providing better interdisciplinary approaches in general medical practice is groundwork

Summary

Introduction

Somatic syndrome is one of the remarkably prevalent issues in primary health care and subspecialty settings [1]. There is abundant information on inter-relationships between physical and mental health in psychosomatic conditions. According to these data, there has to be either an organ dysfunction or a psychological explanation for such symptoms [10]. A Cochrane review in 2014 showed that psychological therapy delivered in primary or secondary care (hospital and outpatient settings, respectively), resulted in less severe symptoms at the end of the treatment [11]

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