Generic and Disease-Specific Mechanisms of Somatic Symptom Persistence Across Diseases (RU SOMACROSS)

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The etiological mechanism of persistent somatic symptoms (PSS) is considered multifactorial, with biological, psychological and social factors involved. While some risk factors and putative mechanisms for PSS in patients with somatoform disorders and functional syndromes have been identified, corresponding scientific studies for PSS in the context of somatic diseases are almost completely lacking. Various studies have investigated individual issues, for example which psychosocial risk factors exist and what role expectations play. However, heterogeneity of the data of previous studies makes it difficult to generate consistent hypotheses with regard to generic risk factors and mechanisms across diseases and syndromes. Therefore, there is a need for comparable, standardized high-quality data and analyses across different diseases and syndromes to consistently assess which factors are generic and which ones are specific for a given condition.The overall aim of the Z-Project is to enable high quality analyses, data pooling, and comparisons across projects by creating a higher-level structure considering content and design across all projects of Research Unit (RU) SOMACROSS. The Project will allow to build a comprehensive structural equation model (SEM) for PSS based on the working model of the RU. This model will describe disease specific as well as joint risk factors and their interplay and allows the development of a prediction model and of a associated risk score.The Project will pool prospective data from the core dataset from the individual projects including ten different medical conditions (total N=1392) and utilizing the core instruments assessed at three identical points in time (baseline, 6- and 12-months follow-up). The database will be created, managed and maintained by the Z-Project. The data collection processes will be managed and supervised by the project. A large number of variables is considered to be relevant to PSS and their interactions are presumed to be complex. Therefore, a longitudinal SEM of somatic symptom persistence across diseases and syndromes will be generated. Furthermore, the Z-Project provides methodological support and interdisciplinary toolboxes regarding methodology, measurement points, core instruments, and outcome measures across all projects.The project will provide an infrastructure to foster interdisciplinary research and will ensure high standards of methodology and comparability for all projects. The expected results of the project include a longitudinal SEM of somatic symptom persistence across diseases and syndromes and a risk score for early identification. In the second funding phase, the final SEM and the resulting risk scores will be validated and calibrated.