Psychiatric disorders comorbid with general medical illnesses and functional somatic disorders: The Lifelines cohort study.
Level 3 - non-randomized controlled study
Prospective population-based cohort study incorporating both cross-sectional and longitudinal incidence analyses
PubMed 37253033 · doi:10.1371/journal.pone.0286410
What was done
Using data from 122,366 adults in the population-based Lifelines cohort study, researchers examined the prevalence and correlates of DSM-IV psychiatric disorders across three functional somatic syndromes (irritable bowel syndrome [IBS], fibromyalgia, chronic fatigue syndrome [CFS]) and three general medical illnesses (inflammatory bowel disease [IBD], rheumatoid arthritis [RA], diabetes). A baseline cross-sectional logistic regression identified variables associated with current psychiatric disorder in those with pre-existing conditions. A longitudinal analysis assessed the baseline prevalence of psychiatric disorders in participants who subsequently developed incident functional or medical conditions between baseline and follow-up.
What was found
Current DSM-IV psychiatric disorder prevalence was higher in functional somatic syndromes (17% to 27%) compared to general medical illnesses (10.4% to 11.7%). Despite this prevalence gap, the factors associated with psychiatric disorders were similar across all conditions: stressful life events, chronic personal health difficulties, neuroticism, poor perception of general health, physical illness-related functional impairment, and prior lifetime psychiatric disorder. In longitudinal analyses, the prevalence of psychiatric disorder prior to condition onset was similar to that observed in established disorders.
Why it matters
These findings suggest that the higher rate of psychiatric comorbidity in functional somatic disorders is largely present before the onset of the somatic syndrome itself, while the psychological and environmental correlates of psychiatric comorbidity remain broadly shared with conventional medical illnesses.
Limits
The six target conditions were based on self-report rather than clinical verification or medical record abstraction. Specific effect sizes, confidence intervals, and exact subgroup participant counts were not reported in the abstract.
Cited by
- supports Fibromyalgia, chronic fatigue syndrome, autoimmune disorders, and IBS are tightly associated with psychological stress and psychiatric disorders.