Clinical Epidemiology (Mar 2023)
High Perceived Stress and Low Self-Efficacy are Associated with Functional Somatic Disorders: The DanFunD Study
Abstract
Marie Weinreich Petersen,1,2 Tina Birgitte Wisbech Carstensen,1,2 Lisbeth Frostholm,1,2 Kaare Bro Wellnitz,1,2 Eva Ørnbøl,1,2 Torben Jørgensen,3,4 Lene Falgaard Eplov,5 Thomas Meinertz Dantoft,3 Per Fink1,2 1Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark; 3Center for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Frederiksberg, Capital Region, Denmark; 4Department of Public Health, Faculty of Medical Sciences, Copenhagen University, Copenhagen, Denmark; 5Copenhagen Research Center for Mental Health – CORE, Mental Health Centre Copenhagen, Copenhagen, Capital Region, DenmarkCorrespondence: Marie Weinreich Petersen, Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus, 8200, Denmark, Tel +45 7846 4310, Email [email protected]: Several psychological factors have been proposed to be associated with functional somatic disorders (FSD) including functional somatic syndromes, such as irritable bowel, chronic widespread pain, and chronic fatigue. However, large randomly selected population-based studies of this association are sparse. This study aimed to investigate the association between FSD and perceived stress and self-efficacy, respectively, and to investigate if FSD differed from severe physical diseases on these aspects.Methods: This cross-sectional study included a random sample of the adult Danish population (n = 9656). FSD were established using self-reported questionnaires and diagnostic interviews. Perceived stress was measured with Cohen’s Perceived Stress Scale and self-efficacy with the General Self-Efficacy Scale. Data were analysed with generalized linear models and linear regression models.Results: FSD were associated with higher perceived stress and lower self-efficacy, especially for the multi-organ and the general symptoms/fatigue FSD types and for chronic fatigue. However, controlling for the personality trait neuroticism altered the associations with self-efficacy so it became insignificant. The analysis did not support an important interaction between perceived stress and self-efficacy on the likelihood of having FSD. Individuals with FSD presented levels of perceived stress that were not equal, ie higher, to those in individuals with severe physical diseases.Conclusion: FSD were positively associated with perceived stress and negatively associated with self-efficacy. Our study may point to stress being part of the symptomatology of FSD. This underlines the severity of having FSD and stresses the relevance of the resilience theory in the understanding of the condition.Keywords: functional somatic disorders, functional somatic syndromes, perceived stress, self-efficacy, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, population-based
