Symptom perception in healthy menopausal women: Can we predict concordance between subjective and physiological measures of vasomotor symptoms?

Abstract

Perception of physical symptoms is an important factor in medical help-seeking. We aimed to examine both physiological and subjective measures of a commonly reported physical symptom-vasomotor symptoms (hot flushes and night sweats; HF/NS), and to investigate factors that might influence symptom perception, that is, concordance, over-reporting, and under-reporting of symptoms in healthy menopausal women. One hundred and forty women completed questionnaires assessing depressed mood, anxiety, stress, somatic symptoms, beliefs about HF/NS, and somatic amplification. Subjective and objective (24-h sternal skin conductance) measurements of HF/NS were obtained to assess concordance. Thirty-seven percent of HF/NS were concordant while 47 and 16 % were under-reported and over-reported, respectively. Depressed mood, anxiety, somatic symptoms, and negative beliefs about HF/NS were associated with (higher) concordance, (less) under-, or (more) over-reporting. Negative beliefs about night sweats and sleep were the strongest predictors of concordance, whereas additional somatic symptoms and smoking predicted over-reporting. Just over one third of physiologically recorded HF/NS were perceived as hot flushes; under-reporting of symptoms was more common than over-reporting. Interestingly, women who were more accurate in detecting physiological HF/NS tended to report more psychological and somatic symptoms and negative beliefs about HF/NS. Both measures should be included as outcomes of clinical trials.