Comorbidities of Patients with Functional Somatic Syndromes Before, During and After First Diagnosis: A Population-based Study using Bavarian Routine Data
Comorbidities of Patients with Functional Somatic Syndromes Before, During and After First Diagnosis: A Population-based Study using Bavarian Routine Data
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DOI：
10.1038/s41598-020-66685-4
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发表时间：
2020-06-17
影响因子：
4.6
通讯作者：
Enck, Paul
中科院分区：
文献类型：
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作者：
Donnachie, Ewan;Schneider, Antonius;Enck, Paul
功能性躯体综合征（FSS）的特征是存在一种或多种不能归因于已知躯体疾病的慢性症状。它们被认为是通过生物和心理社会因素的复杂相互作用而产生的，但尚不清楚它们是否有共同的病因。最近的研究支持的一个假设是，FSS是感染后疾病，这是广泛认可的一个子集的患者患有肠易激综合征。我们的研究使用了诊所医生提交的索赔数据，比较了首次诊断前后五年内患有不同FSS的患者组。即使在诊断前五年，FSS患者也比对照组更频繁地咨询一系列心理和身体状况。诊断后，咨询率进一步增加，并保持在高位。诊断五年后，34%（躯体化障碍）和66%（纤维肌痛）的患者仍在接受治疗。既往胃肠道和上呼吸道感染均与发生FSS的风险增加相关。因此，我们建议应在早期阶段识别有风险的患者，并解决潜在的心理和躯体问题，以防止病情进展。
Functional somatic syndromes (FSS) are characterised by the presence of one or multiple chronic symptoms that cannot be attributed to a known somatic disease. They are thought to arise though a complex interaction of biological and psychosocial factors, but it is unclear whether they share a common aetiology. One hypothesis supported by recent studies is that the FSS are postinfectious disorders, as is widely recognised for a subset of patients with irritable bowel syndrome. Our study used claims data submitted by office-based physicians to compare groups of patients with different FSS in the five years before and after the point of first diagnosis. Even five years prior to diagnosis, FSS patients consulted more frequently for a range of psychological and somatic conditions than did controls. Following diagnosis, consultation rates increased further and remained persistently high. Five years after diagnosis, between 34% (somatization disorder) and 66% (fibromyalgia) of patients were still being treated for the condition. Both prior gastrointestinal and upper-respiratory infection were associated with an increased risk of developing an FSS. We therefore recommend that patients at risk should be identified at an early stage and the underlying psychosocial and somatic issues addressed to prevent progression of the condition.