The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors?
The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors?
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DOI：
10.1093/ije/dyi265
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发表时间：
2006-04-01
影响因子：
7.7
通讯作者：
Macfarlane, GJ
中科院分区：
文献类型：
--
作者：
Aggarwal, VR;McBeth, J;Macfarlane, GJ
背景：没有发现任何物理或病理变化的综合征往往被孤立地研究和处理，尽管假设它们可能是一个实体。我们研究的目的是调查在普通人群中常见的无法解释的症状的共同发生情况，并评估它们是否有共同的关联因素。方法我们进行了一项基于人群的横断面调查，调查对象包括2299名在英格兰西北部全科医学注册的受试者，他们完成了完整的邮寄问卷调查(应答率为72%)。这项研究调查了四种经常无法解释的慢性综合征：慢性广泛性疼痛、慢性口腔面部疼痛、肠易激综合征和慢性疲劳。结果587人(27%)报告了一种或多种症状：404人(18%)报告了一种或多种症状，134人(6%)报告了两种症状，34人(2%)报告了三种症状，15人(1%)报告了所有四种症状。多个综合征的发生比预期的要大(P<；0.001)。女性[优势比(OR)=1.8；95%可信区间(95%CI)1.5-2.2]、高水平的健康焦虑(OR=3.5；95%CI 2.8-4.4)和寻求安慰行为(OR=1.4；95%CI 1.1-1.7)、其他躯体症状的报告(OR=3.6；95%CI 2.9-4.4)、近期不良生活事件的报告(OR=2.3；95%可信区间1.9-2.8)。结论本研究表明，常见的无法解释的慢性综合征在普通人群中同时发生，并具有共同的相关因素。初级保健从业者需要意识到这些特点，以便在一开始就进行适当的管理。
Background Syndromes for which no physical or pathological changes can be found tend to be researched and managed in isolation although hypotheses suggest that they may be one entity. The objectives of our study were to investigate the co-occurrence, in the general population, of syndromes that are frequently unexplained and to evaluate whether they have common associated factors.Methods We conducted a population-based cross-sectional survey that included 2299 subjects who were registered with a General Medical Practice in North-west England and who completed full postal questionnaires (response rate 72%). The study investigated four chronic syndromes that are frequently unexplained: chronic widespread pain, chronic oro-facial pain, irritable bowel syndrome, and chronic fatigue. Validated instruments were used to measure the occurrence of syndromes and to collect information on a variety of associated factors: demographic (age, gender), psychosocial (anxiety, depression, illness behaviour), life stressors, and reporting of somatic symptoms.Results We found that 587 subjects (27%) reported one or more syndromes: 404 (18%) reported one, 134 (6%) reported two, 34 (2%) reported three, and 15 (1%) reported all four syndromes. The occurrence of multiple syndromes was greater than would be expected by chance (P < 0.001). There were factors that were common across syndromes: female gender [odds ratio (OR) = 1.8; 95% confidence interval (95% CI) 1.5-2.2], high levels of aspects of health anxiety like health worry preoccupation (OR = 3.5; 95% CI 2.8-4.4) and reassurance seeking behaviour (OR = 1.4; 95% CI 1.1-1.7), reporting of other somatic symptoms (OR = 3.6; 95% CI 2.9-4.4), and reporting of recent adverse life events (OR = 2.3; 95% CI 1.9-2.8).Conclusion This study has shown that chronic syndromes that are frequently unexplained co-occur in the general population and share common associated factors. Primary care practitioners need to be aware of these characteristics so that management is appropriate at the outset.