FUNCTIONAL DISORDERS 2004

Abstract

Purpose: Recent studies have shown that Functional Disorders (FD) co-occur with Psychiatric Disorders (PD), but whether they share risk factors or are risk factors for each other are unknown. The purpose of this study was to evaluate the association of common FD, including Irritable Bowel Syndrome (IBS), Dyspepsia (DY), Fibromyalgia (FM), Chronic Fatigue Syndrome (CFS), Irritable Bladder (IB), Sexual Dysfunction (SD), Dyspareunia (DP), Migraine (M), Functional Cough (FC), Non-Cardiac Chest Pain (NCCP), PD, other Non-Categorized Disorders (OD) and to assess demographic and psychometric correlates. Methods: Bivariate associations among FD, demographic and psychometric variables were assessed using odds ratios and t-tests. Hierarchical Cluster analysis was used to examine the within-patient aggregation of FD. Results: Of 68 patients with previously diagnosed FD seen at DFC during its first three months, 48 had 3 or more diagnoses (3D). These 3D patients were 6.9 times more likely to have had a traumatic event precede the development of their FD than those with fewer than 3 diagnoses (p <.001) and 90% of 3D patients were women (p <.001). Hierarchical cluster analysis revealed that the most frequent diagnoses, IBS, FM, CFS, and PD tended to group together and formed a cluster separate from other FD in the 3D patients. Psychometric evaluation of 35 3D patients using the SCL-90R and the Quality of Life Inventory showed that those with FM were more obsessive-compulsive (p <.015), depressed (p <.005), and phobic (p <.015), and they also had a higher Global Symptom Index (p <.008) than those without this diagnosis. Those with DP reported lower self-esteem (p <.004) as well as lower overall quality of life (p <.001). Conclusions: These data suggest that there may be common risk factors for many FD and that the symptoms of IBS, FM, CFS, and PD in particular may form a separate syndrome.