Neuroticism, perceived stress, adverse life events and self-efficacy as predictors of the development of functional somatic disorders: longitudinal population-based study (DanFunD)
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark; and Department of Clinical Medicine, University of Aarhus, Denmark
Tina Birgitte Wisbech Carstensen
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark; and Department of Clinical Medicine, University of Aarhus, Denmark
Kaare Bro Wellnitz
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark; and Department of Clinical Medicine, University of Aarhus, Denmark
Eva Ørnbøl
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark; and Department of Clinical Medicine, University of Aarhus, Denmark
Lisbeth Frostholm
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark; and Department of Clinical Medicine, University of Aarhus, Denmark
Thomas Meinertz Dantoft
Center for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Frederiksberg, Denmark
Torben Jørgensen
Center for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Frederiksberg, Denmark; and Department of Public Health, Faculty of Medical Sciences, Copenhagen University, Denmark
Lene Falgaard Eplov
Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Denmark
Per Fink
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark; and Department of Clinical Medicine, University of Aarhus, Denmark
Background Functional somatic disorder (FSD) is a unifying diagnosis that includes functional somatic syndromes such as irritable bowel, chronic widespread pain (CWP) and chronic fatigue. Several psychological factors are associated with FSD. However, longitudinal population-based studies elucidating the causal relationship are scarce. Aims To explore if neuroticism, perceived stress, adverse life events (ALEs) and self-efficacy can predict the development of FSD over a 5-year period. Method A total of 4288 individuals who participated in the DanFunD baseline and 5-year follow-up investigations were included. FSD was established at both baseline and follow-up, with symptom questionnaires and diagnostic interviews. Neuroticism was measured with the short-form NEO Personality Inventory, perceived stress with the Cohen's Perceived Stress Scale, ALEs with the Danish version of the Cumulative Lifetime Adversity Measure and self-efficacy with the General Self-Efficacy Scale. Associations were investigated with multiple logistic regression models. Results Perceived stress predicted incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.04–1.17). Neuroticism predicted incident FSD and chronic fatigue (odds ratios: 1.03–1.16). ALEs predicted incident FSD, CWP and chronic fatigue (odds ratios: 1.06–1.18). An increase in perceived stress from baseline to follow-up was associated with incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.05–1.22). Contrary, an increase in self-efficacy seemed to be a protective factor (odds ratios: 0.89–0.99). Conclusions High neuroticism, high perceived stress and a high number of ALEs are risk factors for the development of FSD. Particularly perceived stress seems to be an important contributor to the onset of FSD.
