Abstract

Prevalence of functional somatic syndromes (FSS) in the general population varies with observed overlap between syndromes. However, studies including a range of FSS are sparse. We investigated prevalence and characteristics of various FSS and the unifying diagnostic construct bodily distress syndrome (BDS), and identified mutual overlap of the FSS and their overlap with BDS. We included a stratified subsample of 1590 adults from a randomly selected Danish general population sample (n = 7493). Telephonic diagnostic interviews performed by three trained physicians were used to identify individuals with FSS and BDS. Prevalence of overall FSS was 9.3%; 3.8% for irritable bowel, 2.2% for chronic widespread pain, 6.1% for chronic fatigue, 1.5% for whiplash associated disorders, and 0.9% for multiple chemical sensitivity. Prevalence of BDS was 10.7% where 2.0% had the multi-organ type. FSS were highly overlapping with low likelihood of having a “pure” type. Diagnostic agreement of FSS and BDS was 92.0%. Multi-syndromatic FSS and multi-organ BDS were associated with female sex, poor health, physical limitations, and comorbidity. FSS are highly prevalent and overlapping, and multi-syndromatic cases are most affected. BDS captured the majority of FSS and may improve clinical management, making the distinction between multi- and mono-syndromatic patients easier.

Highlights

  • Prevalence of functional somatic syndromes (FSS) in the general population varies with observed overlap between syndromes

  • The objectives of this study were to establish prevalence and characteristics of a range of functional somatic disorders (FSD) using two diagnostic approaches: 1) Five FSS (IB, CWP, chronic fatigue (CF), whiplash associated disorders (WAD) and multiple chemical sensitivity (MCS)) and 2) bodily distress syndrome (BDS) in the general Danish population using a diagnostic interview performed by trained physicians

  • With a median age of 56 years (IQR: 46–64, p = 0.003), decliners were older than interviewees and had lower risk of a poor self-perceived health (22.7% of interviewees had a poor self-perceived health compared to 16.7% of decliners, RR: 1.4, 95% CI: 1.2–1.6, p < 0.001) and limitations in daily activities (26.2% of interviewees had limitations in daily activities compared to 19.2% of decliners, RR: 1.4, 95% CI: 1.2–1.6, p < 0.001)

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Summary

Introduction

Prevalence of functional somatic syndromes (FSS) in the general population varies with observed overlap between syndromes. Functional somatic syndromes (FSS), such as irritable bowel syndrome (IBS), fibromyalgia/chronic widespread pain (FM/CWP), chronic fatigue syndrome (CFS), whiplash associated disorders (WAD), and multiple chemical sensitivity (MCS), are prevalent in various medical settings and cause great impairment in patients and high health care costs for society. In order to meet this issue, the unifying diagnostic construct, bodily distress syndrome (BDS) has been proposed[30,31]. It presents with four subtypes of symptom clusters; a cardiopulmonary (CP) type, a gastrointestinal (GI) type, a musculoskeletal (MS) type, and a general symptoms (GS)/fatigue type. We use irritable bowel (IB) for describing IBS, CWP to describe FM, and chronic fatigue (CF) for describing CFS

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