The overlooked burden of persistent physical symptoms: a call for action in European healthcare
Open accessAbstract
Regardless of their cause, persistent physical symptoms are distressing somatic complaints that occur on most days for at least several months. They are common in patients with somatic diseases, functional somatic disorders, mental disorders, and undiagnosed medical conditions and are often associated with significant impairment and medical costs. Despite their prevalence and impact, persistent physical symptoms are often overlooked in medical care. This Personal View stresses the importance of recognising persistent physical symptoms as a European health issue. It advocates improvements in research, clinical management, public health, and policy. Efforts should prioritise integrating models of symptom perception and biopsychosocial perspectives into medical care and education, fostering interdisciplinary collaboration, and developing standardised guidelines to enhance patient care, reduce stigma, and improve clinical outcomes. Increased research funding can accelerate progress in understanding and effectively managing persistent physical symptoms. Addressing these priorities will support patients and healthcare professionals, ensuring adequate care and a higher quality of life for affected individuals.
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These symptoms often persist, negatively affecting work ability and daily life.
“These symptoms often persist, negatively affecting work ability and daily life [1, 2].”
PPS warrant attention due to their prevalence and association with poorer health, work disability, increased healthcare use, and high societal costs.
“PPS warrant attention due to their prevalence and association with poorer health, work disability, increased healthcare use, and high societal costs [1, 4].”
Individualized case formulation in a patient-centered manner may further enhance treatment acceptability and effectiveness.
“Self-management and web-based treatments show promise in increasing accessibility [33, 34], and individualized case formulation in a patient-centered manner may further enhance treatment acceptability and effectiveness [1, 35].”
The inadequate recognition, treatment, and rehabilitation of PPS underscore the need for evidence-based treatment pathways to enhance care, reduce stigma, and improve clinical outcomes.
“The inadequate recognition, treatment, and rehabilitation of PPS underscore the need for evidence-based treatment pathways to enhance care, reduce stigma, and improve clinical outcomes [1].”
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Cites
Patient engagement in research: a systematic review
Domecq, J. P., Prutsky, G., Elraiyah, T., Wang, Z., Nabhan, M., Shippee, N., Brito, J. P., Boehmer, K., Hasan, R., Firwana, B., et al. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-89 · Cited by 1,773 · see citing works
Sleep Complaints Among Elderly Persons: An Epidemiologic Study of Three Communities
Foley, D. J., Monjan, A. A., Brown, S. L., Simonsick, E. M., Wallace, R. B., & Blazer, D. G. (1995) · Sleep · doi:10.1093/sleep/18.6.425 · Cited by 1,610 · see citing works
O’Mahoney, L. L., Routen, A. C., Gillies, C. L., Ekezie, W. C., Welford, A. E., Zhang, A., Karamchandani, U., Simms-Williams, N., Cassambai, S., Ardavani, A., et al. (2022) · EClinicalMedicine · doi:10.1016/j.eclinm.2022.101762 · Cited by 797 · cited 1× · see citing works
“41,42 Distressing symptoms can also accompany chronic somatic diseases (e.g., gastro-intestinal complaints in ulcerative colitis 2 ) and may not be alleviated by treatments targeting the pathophysiology or structural sequelae of the underlying disease.”
Loeser, J. D., & Melzack, R. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01311-2 · Cited by 700 · cited 1× · see citing works
“41,42 Distressing symptoms can also accompany chronic somatic diseases (e.g., gastro-intestinal complaints in ulcerative colitis 2 ) and may not be alleviated by treatments targeting the pathophysiology or structural sequelae of the underlying disease.”
Patients presenting with somatic complaints: epidemiology, psychiatric co‐morbidity and management
Kroenke, K. (2003) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.140 · Cited by 624 · cited 2× · see citing works
“26,27 Persistent physical symptoms also affect children, adolescents, and the elderly.”
Unexplained post-acute infection syndromes
Choutka, J., Jansari, V., Hornig, M., & Iwasaki, A. (2022) · Nature Medicine · doi:10.1038/s41591-022-01810-6 · Cited by 604 · see citing works
Patients' unvoiced agendas in general practice consultations: qualitative study
Barry, C. A. (2000) · BMJ · doi:10.1136/bmj.320.7244.1246 · Cited by 585 · cited 1× · see citing works
“38 Persistent physical symptoms are not a medical condition or diagnosis, but they are a core feature of many medical conditions, including somatic diseases, functional somatic disorders, mental disorders, and undiagnosed medical conditions.”
Symptoms and the body: taking the inferential leap
Van den Bergh, O., Witthöft, M., Petersen, S., & Brown, R. J. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.01.015 · Cited by 543 · cited 2× · see citing works
“52 Panel 2 summarizes the need to take a biopsychosocial perspective in the understanding of persistent physical symptoms and provides suggestions on how to achieve this.”
Self-citationFunctional neurological disorder: new subtypes and shared mechanisms
Hallett, M., Aybek, S., Dworetzky, B. A., McWhirter, L., Staab, J. P., & Stone, J. (2022) · The Lancet Neurology · doi:10.1016/s1474-4422(21)00422-1 · Cited by 538 · cited 1× · see citing works
“47 A different understanding also underlies the diagnostic category of functional neurological disorders (FND), 48 which are one of the most common conditions in neurological practice.”
Self-citationEpidemiology of Pediatric Functional Abdominal Pain Disorders: A Meta-Analysis
Korterink, J. J., Diederen, K., Benninga, M. A., & Tabbers, M. M. (2015) · PLOS ONE · doi:10.1371/journal.pone.0126982 · Cited by 481 · cited 1× · see citing works
“About 25% of children and adolescents experience pain-related symptoms such as chronic abdominal pain, 28 migraines or headaches, 29 but also persistent fatigue, 30 irritable bowel symptoms, or dyspepsia.”
Management of chronic pain in older adults
Reid, M. C., Eccleston, C., & Pillemer, K. A. (2015) · BMJ · doi:10.1136/bmj.h532 · Cited by 407 · see citing works
The Epidemiology of Childhood Recurrent Abdominal Pain in Western Countries: A Systematic Review
Chitkara, D. K., Rawat, D. J., & Talley, N. J. (2005) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2005.41893.x · Cited by 359 · see citing works
Cultural Models and Somatic Syndromes
Kirmayer, L. J., & Sartorius, N. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31815b002c · Cited by 334 · cited 2× · see citing works
“59 Social stressors and cultural factors, 60 such as negative encounters with healthcare professionals or employers, and general population prejudice, also negatively affect symptom courses.”
Henningsen, P., Gündel, H., Kop, W. J., Löwe, B., Martin, A., Rief, W., Rosmalen, J. G. M., Schröder, A., van der Feltz-Cornelis, C., & Van den Bergh, O. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000588 · Cited by 310 · cited 1× · see citing works
“6 Models of predictive processing provide a general framework of perceptual processes for persistent physical symptoms.”
Self-citationThe Lancet Series call to action to reduce low value care for low back pain: an update
Buchbinder, R., Underwood, M., Hartvigsen, J., & Maher, C. G. (2020) · Pain · doi:10.1097/j.pain.0000000000001869 · Cited by 300 · see citing works
Schedules for clinical assessment in neuropsychiatry
Rehman, F. (2011) · BMJ · doi:10.1136/bmj.c7160 · Cited by 298 · see citing works
on behalf of the EURONET-SOMA Group, Burton, C., Fink, P., Henningsen, P., Löwe, B., & Rief, W. (2020) · BMC Medicine · doi:10.1186/s12916-020-1505-4 · Cited by 292 · see citing works
Self-citationPersistent physical symptoms: definition, genesis, and management
Löwe, B., Toussaint, A., Rosmalen, J. G. M., Huang, W.-L., Burton, C., Weigel, A., Levenson, J. L., & Henningsen, P. (2024) · The Lancet · doi:10.1016/s0140-6736(24)00623-8 · Cited by 280 · cited 5× · see citing works
“1,2,58,62 For instance, chronic pain may be exacerbated by stress or lack of social support, whether it arises from tissue damage or in fl ammation or not.”
InfluentialSelf-citationTalley, N. J., Dennis, E. H., Schettler-Duncan, V. A., Lacy, B. E., Olden, K. W., & Crowell, M. D. (2003) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07699.x · Cited by 239 · see citing works
The role of psychological interventions in the management of patients with chronic pain
Roditi, D., & Roditi (2011) · Psychology Research and Behavior Management · doi:10.2147/prbm.s15375 · Cited by 217 · see citing works
Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis
Löwe, B., Levenson, J., Depping, M., Hüsing, P., Kohlmann, S., Lehmann, M., Shedden-Mora, M., Toussaint, A., Uhlenbusch, N., & Weigel, A. (2022) · Psychological Medicine · doi:10.1017/s0033291721004177 · Cited by 217 · cited 1× · see citing works
“50 Although somatic symptom disorder can be diagnosed alongside a somatic disease, it is rarely used outside of psychosomatic medicine or clinical psychology.”
Self-citation“Unexplained” Somatic Symptoms, Functional Syndromes, and Somatization: Do We Need a Paradigm Shift?
Sharpe, M., & Carson, A. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-9_part_2-200105011-00018 · Cited by 209 · cited 1× · see citing works
“79 Early symptom management can be facilitated by identifying patients at risk for persistent symptoms based on repeated consultations, multiple or increasing symptoms, perceived distress, and impaired functioning.”
The Biopsychosocial Model Thirty Years Later
Fava, G. A., & Sonino, N. (2007) · Psychotherapy and Psychosomatics · doi:10.1159/000110052 · Cited by 190 · cited 1× · see citing works
“51 This view neglects modern models of symptom perception and the process of disease-related information being relayed from the body to the brain and mind.”
Adolescent Chronic Fatigue Syndrome: Prevalence, Incidence, and Morbidity
Nijhof, S. L., Maijer, K., Bleijenberg, G., Uiterwaal, C. S. P. M., Kimpen, J. L. L., & van de Putte, E. M. (2011) · Pediatrics · doi:10.1542/peds.2010-1147 · Cited by 162 · see citing works
Dahlhausen, F., Zinner, M., Bieske, L., Ehlers, J. P., Boehme, P., & Fehring, L. (2021) · JMIR mhealth and uhealth · doi:10.2196/33012 · Cited by 139 · cited 1× · see citing works
“102 Panel 3 summarizes the need to provide effective healthcare for patients with persistent physical symptoms across countries and healthcare settings.”
A Practical and Evidence-Based Approach to Common Symptoms: A Narrative Review
Kroenke, K. (2014) · Annals of Internal Medicine · doi:10.7326/m14-0461 · Cited by 132 · see citing works
Boronat, A. C., Ferreira-Maia, A. P., Matijasevich, A., & Wang, Y. (2017) · World Journal of Gastroenterology · doi:10.3748/wjg.v23.i21.3915 · Cited by 132 · cited 1× · see citing works
“31 In the elderly population, chronic pain affects 25 – 50% of those living in the community and up to 80% of those in nursing homes.”
Joustra, M. L., Janssens, K. A. M., Bültmann, U., & Rosmalen, J. G. M. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.05.004 · Cited by 131 · cited 1× · see citing works
“45,46 Some of these diagnoses are still made by exclusion, i.e., the presence of physical or organic disease is ruled out as a pre-requisite for making the diagnosis.”
Self-citationRief, W., Burton, C., Frostholm, L., Henningsen, P., Kleinstäuber, M., Kop, W. J., Löwe, B., Martin, A., Malt, U., Rosmalen, J., et al. (2017) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000502 · Cited by 129 · see citing works
Self-citationElnegaard, S., Andersen, R. S., Pedersen, A. F., Larsen, P. V., Søndergaard, J., Rasmussen, S., Balasubramaniam, K., Svendsen, R. P., Vedsted, P., & Jarbøl, D. E. (2015) · BMC Public Health · doi:10.1186/s12889-015-2034-5 · Cited by 127 · cited 1× · see citing works
“23 These symptoms are most often the reason for patients to consult healthcare, they generate 30 – 60% of family practitioners ’ workload 23 and are frequent in specialised healthcare.”
Nijs, J., Kosek, E., Chiarotto, A., Cook, C. E., Danneels, L. A., Fernández‐de‐las‐Peñas, C., Hodges, P. W., Koes, B. W., Louw, A., Ostelo, R., et al. (2024) · The Lancet Rheumatology · doi:10.1016/s2665-9913(23)00324-7 · Cited by 125 · see citing works
Löwe, B., Andresen, V., Van den Bergh, O., Huber, T. B., von dem Knesebeck, O., Lohse, A. W., Nestoriuc, Y., Schneider, G., Schneider, S. W., Schramm, C., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-057596 · Cited by 121 · cited 13× · see citing works
“Panel 5 outlines the need for high-quality research and offers suggestions for achieving it.”
InfluentialSelf-citationJohansen, M., & Risør, M. B. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.11.015 · Cited by 120 · see citing works
Everitt, H. A., Landau, S., O'Reilly, G., Sibelli, A., Hughes, S., Windgassen, S., Holland, R., Little, P., McCrone, P., Bishop, F. L., et al. (2019) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(19)30243-2 · Cited by 116 · see citing works
Roenneberg, C., Sattel, H., Schaefert, R., Henningsen, P., & Hausteiner-Wiehle, C. (2019) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2019.0553 · Cited by 111 · cited 1× · see citing works
“83 Although existing guidelines are unanimous in these treatment steps, 84 – 86 European countries differ signi fi - cantly in guideline availability, fi nancing of evidence-based treatments, and availability of specialised care structures for persistent physical symptoms.”
Association of costs with somatic symptom severity in patients with medically unexplained symptoms
Konnopka, A., Kaufmann, C., König, H.-H., Heider, D., Wild, B., Szecsenyi, J., Herzog, W., Heinrich, S., & Schaefert, R. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.08.011 · Cited by 109 · cited 1× · see citing works
“37 Despite their overwhelming prevalence and associated burden, persistent physical symptoms frequently receive little attention and are not systematically assessed or discussed with patients during medical consultations, especially if a disease diagnosis has already been established.”
Self-citationAiarzagüena, J. M., Gonzalo Grandes, O., Gaminde, I., Salazar, A., Sánchez, Á., & Ariño, J. (2006) · Psychological Medicine · doi:10.1017/s0033291706009536 · Cited by 98 · cited 1× · see citing works
“71 There is guidance for family doctors in how to address the needs of patients with persistent physical symptoms during consultations.”
Langlois, P., Perrochon, A., David, R., Rainville, P., Wood, C., Vanhaudenhuyse, A., Pageaux, B., Ounajim, A., Lavallière, M., Debarnot, U., et al. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104591 · Cited by 94 · cited 1× · see citing works
“2 The strongest evidence for treatment includes psychological therapies like cognitive behavioural and dynamic psychotherapy, hypnosis, 74 – 77 and, in some cases, pharmacological treatments (e.g., antidepressants 2 ).”
Kube, T., Rozenkrantz, L., Rief, W., & Barsky, A. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101829 · Cited by 91 · cited 1× · see citing works
“60,64 Persistent physical symptoms thus involve neurobiological mechanisms of perceptual dysregulation integrating patients ’ knowledge, prior experience, and expectations about symptoms.”
Self-citationThe overlap of somatic, anxious and depressive syndromes: A population-based analysis
Kohlmann, S., Gierk, B., Hilbert, A., Brähler, E., & Löwe, B. (2016) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2016.09.004 · Cited by 90 · see citing works
Self-citationLalouni, M., Ljótsson, B., Bonnert, M., Ssegonja, R., Benninga, M., Bjureberg, J., Högström, J., Sahlin, H., Simrén, M., Feldman, I., et al. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.11.043 · Cited by 88 · cited 1× · see citing works
“99,100 These applications usually focus on education and self-help interventions and aim to improve quality of life and reduce somatic symptoms.”
Management of the multiple symptoms of irritable bowel syndrome
Simrén, M., Törnblom, H., Palsson, O. S., & Whitehead, W. E. (2017) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(16)30116-9 · Cited by 82 · cited 1× · see citing works
“17,82 Of course, any treatment is initially subject to managing the pathophysiological or structural cause of the persistent somatic symptoms.”
Smakowski, A., Hüsing, P., Völcker, S., Löwe, B., Rosmalen, J. G. M., Mora, M. C. S., & Toussaint, A. C. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.111608 · Cited by 81 · see citing works
Self-citationSuicide and suicidality in somatic symptom and related disorders: a systematic review
Torres, M. E., Löwe, B., Schmitz, S., Pienta, J. N., Van Der Feltz-Cornelis, C., & Fiedorowicz, J. G. (2021) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110290 · Cited by 80 · see citing works
Self-citationPetersen, M. W., Schröder, A., Jørgensen, T., Ørnbøl, E., Dantoft, T. M., Eliasen, M., Carstensen, T. W., Falgaard Eplov, L., & Fink, P. (2020) · Scandinavian Journal of Public Health · doi:10.1177/1403494819868592 · Cited by 76 · cited 1× · see citing works
“45,46 Some of these diagnoses are still made by exclusion, i.e., the presence of physical or organic disease is ruled out as a pre-requisite for making the diagnosis.”
Self-citationAvlund, K., Pedersen, A. N., & Schroll, M. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000082640.61645.bf · Cited by 71 · see citing works
Persistent Postural-Perceptual Dizziness
Staab, J. P. (2023) · Neurologic Clinics · doi:10.1016/j.ncl.2023.04.003 · Cited by 70 · see citing works
Biomechanical and phenomenological models of the body, the meaning of illness and quality of care
Marcum, J. A. (2005) · Medicine Health Care and Philosophy · doi:10.1007/s11019-004-9033-0 · Cited by 67 · see citing works
Medically unexplained symptoms: the person, the symptoms and the dialogue
Houwen, J., Lucassen, P. L., Stappers, H. W., Assendelft, W. J., van Dulmen, S., & Hartman, T. O. (2016) · Family Practice · doi:10.1093/fampra/cmw132 · Cited by 67 · see citing works
Self-citationLeaviss, J., Davis, S., Ren, S., Hamilton, J., Scope, A., Booth, A., Sutton, A., Parry, G. D., Buszewicz, M., Moss-Morris, R. E., et al. (2020) · Health Technology Assessment · doi:10.3310/hta24460 · Cited by 67 · see citing works
Rosmalen, J. G. M., Burton, C. D., Carson, A. J., Cosci, F., Frostholm, L., Lehnen, N., Hartman, T. O., Rask, C. U., Rymaszewska, J., Stone, J., et al. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110345 · Cited by 67 · see citing works
Self-citationEffect of Collaborative Care on Persistent Postconcussive Symptoms in Adolescents
McCarty, C. A., Zatzick, D., Marcynyszyn, L. A., Wang, J., Hilt, R. J., Jinguji, T. M., Quitiquit, C., Chrisman, S. P. D., & Rivara, F. P. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.0207 · Cited by 65 · cited 1× · see citing works
“90 Several European countries have established specialised treatment centres for certain subtypes of persistent somatic symptoms, such as chronic pain (e.g., pain clinics across the UK and Germany) or functional somatic disorders (e.g., Danish regional centres for functional somatic disorders)…”
Shen, Q., Joyce, E. E., Ebrahimi, O. V., Didriksen, M., Lovik, A., Sævarsdóttir, K. S., Magnúsdóttir, I., Mikkelsen, D. H., Unnarsdóttir, A. B., Hauksdóttir, A., et al. (2023) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2023.100756 · Cited by 62 · see citing works
Knapstad, M., Lervik, L. V., Sæther, S. M. M., Aarø, L. E., & Smith, O. R. F. (2019) · Psychotherapy and Psychosomatics · doi:10.1159/000504453 · Cited by 61 · cited 1× · see citing works
“96,97 European-wide care standards could be improved by joint management guidelines that are practical, culturally sensitive, and feasible for implementation into time-restricted routine care, taking structural differences between healthcare systems into account.”
Schnabel, K., Petzke, T. M., & Witthöft, M. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102196 · Cited by 61 · see citing works
Self-citationChalder, T., & Willis, C. (2017) · Journal of Mental Health · doi:10.1080/09638237.2017.1322187 · Cited by 59 · cited 1× · see citing works
“39 This transdiagnostic perspective not only facilitates communication between clinicians from different medical fi elds, but also enables an understanding of why people experience multiple and overlapping symptoms and why symptoms may persist or recur over time.”
Bova, G., Domenichiello, A., Letzen, J. E., Rosenberger, D. C., Siddons, A., Kaiser, U., Anicich, A., Baron, R., Birch, J., Bouhassira, D., et al. (2023) · eClinicalMedicine · doi:10.1016/j.eclinm.2023.102340 · Cited by 56 · see citing works
Stigma in functional neurological disorder (FND) – A systematic review
McLoughlin, C., McWhirter, L., Pisegna, K., Tijssen, M. A. J., Tak, L. M., Carson, A. J., & Stone, J. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102460 · Cited by 56 · see citing works
Self-citationPrevalence of functional disorders across Europe: a systematic review and meta-analysis
Rometsch, C., Mansueto, G., Bermpohl, F. M. G., Martin, A., & Cosci, F. (2024) · European Journal of Epidemiology · doi:10.1007/s10654-024-01109-5 · Cited by 54 · cited 2× · see citing works
“44 Across Europe, the estimated point prevalence of functional disorders in adult populations is 8%, 10 whereas prevalence rates differ considerably between individual disorders and throughout European countries.”
Self-citationHouwen, J., Lucassen, P. L., Stappers, H. W., Assendelft, W. J., van Dulmen, S., & Hartman, T. O. (2017) · British Journal of General Practice · doi:10.3399/bjgp17x692537 · Cited by 53 · cited 1× · see citing works
“69 A recent pan-European study across 16 countries identi fi ed fi ve main explanatory approaches healthcare professionals use to explain persistent physical symptoms.”
Self-citationIncorporating Biopsychosocial Characteristics into Personalized Healthcare: A Clinical Approach
Evers, A. W. M., Gieler, U., Hasenbring, M. I., & van Middendorp, H. (2014) · Psychotherapy and Psychosomatics · doi:10.1159/000358309 · Cited by 49 · cited 1× · see citing works
“70 ‘ Sensitised alarm ’ and ‘ malfunctioning software ’ are both approaches derived from neurosciences.”
Course and predictors of medically unexplained pain symptoms in the general population
Leiknes, K. A., Finset, A., Moum, T., & Sandanger, I. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.08.009 · Cited by 48 · see citing works
Clinical signs in functional cognitive disorders: A systematic review and diagnostic meta-analysis
Cabreira, V., Frostholm, L., McWhirter, L., Stone, J., & Carson, A. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111447 · Cited by 43 · see citing works
Self-citationThe Amplification of Symptoms in the Medically Ill
BARSKY, A. J., & Silbersweig, D. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-022-07699-8 · Cited by 41 · see citing works
Burton, C., Mooney, C., Sutton, L., White, D., Dawson, J., Neilson, A. R., Rowlands, G., Thomas, S., Horspool, M., Fryer, K., et al. (2024) · The Lancet · doi:10.1016/s0140-6736(24)00700-1 · Cited by 39 · cited 2× · see citing works
“73 Based on scienti fi c knowledge about persistent physical symptoms, it comprises four components: Recognition seeks to validate the patient ’ s experience and emphasize the clinician ’ s recognition of the problem as legitimate.”
Self-citationKohlmann, S., Löwe, B., & Mora, M. C. S. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00646 · Cited by 37 · cited 1× · see citing works
“87 In resource-poor areas, unequal access to treatment leads to higher disability estimates.”
Self-citationSomatic Symptoms in the German General Population from 1975 to 2013
Beutel, M. E., Klein, E. M., Henning, M., Werner, A. M., Burghardt, J., Tibubos, A. N., Schmutzer, G., & Brähler, E. (2020) · Scientific Reports · doi:10.1038/s41598-020-58602-6 · Cited by 35 · cited 1× · see citing works
“54 Predisposing factors include sociodemographics (e.g., being female, 55 low socioeconomic status 56 ), psychological factors (e.g., adverse childhood or life experiences, neuroticism), 57 and biomedical aspects (e.g., prior diseases, genetic pro fi les, immunological factors).”
Horwitz, R. I., Singer, B. H., Conroy, A. H., Cullen, M. R., Mawn, M., Colella, K., & Sim, I. (2022) · Psychotherapy and Psychosomatics · doi:10.1159/000521567 · Cited by 35 · cited 1× · see citing works
“54 Predisposing factors include sociodemographics (e.g., being female, 55 low socioeconomic status 56 ), psychological factors (e.g., adverse childhood or life experiences, neuroticism), 57 and biomedical aspects (e.g., prior diseases, genetic pro fi les, immunological factors).”
Hulgaard, D., Dehlholm‐Lambertsen, G., & Rask, C. U. (2019) · Journal of Family Therapy · doi:10.1111/1467-6427.12199 · Cited by 34 · cited 1× · see citing works
“68 Panel 2 : A biopsychosocial understanding and acceptable explanatory models for persistent physical symptoms are needed.”
Self-citationUnderstanding fatigue in primary biliary cholangitis: From pathophysiology to treatment perspectives
Lynch, E. N., Campani, C., Innocenti, T., Dragoni, G., Biagini, M. R., Forte, P., & Galli, A. (2022) · World Journal of Hepatology · doi:10.4254/wjh.v14.i6.1111 · Cited by 34 · cited 1× · see citing works
“43 Notably, one-third of patients presenting symptoms in medical care do not receive a disease diagnosis.”
Dear, B. F., Scott, A. J., Fogliati, R., Gandy, M., Karin, E., Dudeney, J. E., Nielssen, O. B., McDonald, S., Heriseanu, A. I., Bisby, M. A., et al. (2022) · Psychotherapy and Psychosomatics · doi:10.1159/000522530 · Cited by 31 · cited 1× · see citing works
“40 Sometimes, physical symptoms occur as indicators of somatic disease and can persist even after the original cause has subsided, e.g., pain after an injury or post-infectious fatigue.”
Saunders, C., Treufeldt, H., Rask, M. T., Pedersen, H. F., Rask, C. U., Burton, C. D., & Frostholm, L. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111155 · Cited by 27 · see citing works
Self-citationWu, Y., Hanson, S. W., Culbreth, G. T., Purcell, C. A., Brooks, P., Kopec, J. A., MARCH, L. M., Woolf, A. D., Pasovic, M., Hamilton, E. B., et al. (2024) · The Lancet Rheumatology · doi:10.1016/s2665-9913(24)00151-6 · Cited by 26 · cited 1× · see citing works
“88 In Germany, psychosomatic medicine is an independent specialty integrating psychological and somatic aspects on an equal and reciprocal basis.”
Symptoms as the main problem: a cross- sectional study of patient experience in primary care
Rosendal, M., Carlsen, A. H., & Rask, M. T. (2016) · BMC Family Practice · doi:10.1186/s12875-016-0429-8 · Cited by 25 · see citing works
Self-citationSwainston, K., Thursby, S., Bell, B., Poulter, H., Dismore, L., & Copping, L. (2023) · British Journal of Health Psychology · doi:10.1111/bjhp.12613 · Cited by 25 · cited 1× · see citing works
“78 In terms of treatment pathways, care for persistent physical symptoms has typically been equated with ruling out biomedical diseases.”
Kluge, H. H. P., Muscat, N. A., Mishra, S., Nielsen, S., Tille, F., Pfeifer, D., Europe, L. C., & Sivan, M. (2022) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2022.100435 · Cited by 23 · see citing works
Bräscher, A., Sütterlin, S., Scheuren, R., den Bergh, O. V., & Witthöft, M. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000824 · Cited by 22 · cited 1× · see citing works
“65 As symptoms persist, their link to clearly identi fi able pathophysiology often weakens.”
Self-citationCharacteristics of collaborative care networks in functional disorders: A systematic review
Mamo, N., van de Klundert, M. A. W., Tak, L. M., Hartman, T. O., Hanssen, D. J. C., & Rosmalen, J. G. M. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111357 · Cited by 22 · cited 1× · see citing works
“17,82 Of course, any treatment is initially subject to managing the pathophysiological or structural cause of the persistent somatic symptoms.”
Self-citationRussell, L. A., Abbass, A. A., & Allder, S. J. (2022) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2022.108657 · Cited by 20 · see citing works
Relationships between catastrophic thought, bodily sensations and physical symptoms
Seto, H., & Nakao, M. (2017) · BioPsychoSocial Medicine · doi:10.1186/s13030-017-0110-z · Cited by 19 · see citing works
The Predictors of Somatic Symptoms in a Population Sample: The Lifelines Cohort Study
Creed, F. H. (2022) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001101 · Cited by 19 · cited 2× · see citing works
“2,58 Triggering factors such as acute infections, injuries, medical procedures, and life events can initiate short-term somatic symptoms.”
Pain research in 2023: towards understanding chronic pain
Sommer, C., & Rittner, H. L. (2023) · The Lancet Neurology · doi:10.1016/s1474-4422(23)00446-5 · Cited by 19 · cited 1× · see citing works
“63 Dysfunctional explicit and implicit expectations might contribute to the development and persistence of symptoms, in fl uenced by a complex interplay of factors promoting a lowered threshold to the perception of physical symptoms such as emotional states or cognitive biases, social norms and…”
McGhie-Fraser, B., Lucassen, P. L., Ballering, A., Abma, I. L., Brouwers, E. P. M., van Dulmen, S., & Hartman, T. O. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111161 · Cited by 18 · see citing works
Self-citationKustra-Mulder, A., Löwe, B., & Weigel, A. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111485 · Cited by 18 · cited 1× · see citing works
“18 A focus group study from the Netherlands identi fi ed strategies to enhance collaborative care, including professional education, communication, care coordination, care pathways, joint consultations, funding, patient involvement, and prevention.”
Self-citationTreufeldt, H., & Burton, C. D. (2024) · Patient Education and Counseling · doi:10.1016/j.pec.2024.108198 · Cited by 18 · see citing works
Self-citationPatients With Somatoform Disorders Are Prone To Expensive and Potentially Harmful Medical Procedures
Schneider, A., Donnachie, E., Zipfel, S., & Enck, P. (2021) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2021.0135 · Cited by 17 · see citing works
Kaur, T., Ranjan, P., Sarkar, S., Kaloiya, G. S., Khan, M., ., A., & Bhatia, H. (2022) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2022.04.006 · Cited by 17 · cited 1× · see citing works
“2 The strongest evidence for treatment includes psychological therapies like cognitive behavioural and dynamic psychotherapy, hypnosis, 74 – 77 and, in some cases, pharmacological treatments (e.g., antidepressants 2 ).”
Atasoy, S., Henningsen, P., Sattel, H. C., Baumert, J. J., Rückert‐Eheberg, I., Kraus, U., Peters, A., Ladwig, K., & Hausteiner‐Wiehle, C. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111022 · Cited by 17 · see citing works
Self-citationRosmalen, J. G. M., van Gils, A., Acevedo-Mesa, A., Schoevers, R. A., Monden, R., & Hanssen, D. J. C. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100297 · Cited by 15 · cited 1× · see citing works
“80,98 Particularly in medically under-served rural areas or European countries with fewer care capacities, the allocation of limited resources could be optimised by providing patients with digital health applications, where complex topics can be conveyed, with or without direct healthcare…”
Self-citationKustra-Mulder, A., Liebau, M., Grewer, G., Rosmalen, J. G. M., Cosci, F., Rymaszewska, J., Löwe, B., & Weigel, A. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.111695 · Cited by 15 · cited 1× · see citing works
“94 Evidence from a scoping review suggests that health outcomes in patients with persistent physical symptoms are in fl uenced by levels of care, with the highest symptom improvement and lowest persistence rates in specialised care settings as compared to primary or secondary care settings.”
Self-citationMünker, L., Rimvall, M. K., Frostholm, L., Ørnbøl, E., Wellnitz, K. B., Jeppesen, P., Rosmalen, J. G. M., & Rask, C. U. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05937-3 · Cited by 15 · see citing works
Self-citationAddressing the needs of patients with medically unexplained symptoms: 10 key messages
Hartman, T. O., Lam, C. L. K., Usta, J., Clarke, D., Fortes, S., & Dowrick, C. F. (2018) · British Journal of General Practice · doi:10.3399/bjgp18x698813 · Cited by 14 · cited 1× · see citing works
“72 The REAL (Recognition, Explanation, Action, Learning) model is a best practice example.”
Self-citationMariman, A., Vermeir, P., Csabai, M., Weiland, A., Stegers‐Jager, K. M., Vermeir, R., & Vogelaers, D. (2023) · European journal of medical research · doi:10.1186/s40001-023-01105-7 · Cited by 14 · cited 1× · see citing works
“67 For younger patients, including the family and wider network (e.g., school) in symptom explanation and management is often crucial.”
Matta, J., Wiernik, E., Robineau, O., Severi, G., Touvier, M., Gouraud, C., Vedrines, C. O., Pitron, V., Ranque, B., Hoertel, N., et al. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111326 · Cited by 13 · see citing works
Self-citationPatel, M., James, K., Moss-Morris, R. E., Husain, M., Ashworth, M. J., Frank, P., Ferreira, N., Mosweu, I., McCrone, P., Hotopf, M. H., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-025513 · Cited by 12 · cited 1× · see citing works
“European funding also supported the development and evaluation of targeted, patient-centred treatments, 111 training measures, 112 and collaborative care concepts.”
Rask, M. T., Frostholm, L., Hansen, S. H., Petersen, M. W., Ørnbøl, E., & Rosendal, M. (2023) · Health Psychology Review · doi:10.1080/17437199.2022.2163917 · Cited by 12 · cited 1× · see citing works
“101 In some European countries, digital health applications can already be prescribed by health professionals and are covered by statutory health insurance.”
Self-citationWeigel, A., Hüsing, P., Junge, M., & Löwe, B. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111419 · Cited by 12 · cited 1× · see citing works
“66 Shared explanatory models can counteract stigma, provide empowerment and reassurance, and facilitate treatment adherence by fostering hope for coping with or recovering from symptoms.”
Self-citationMamo, N., Tak, L. M., Hartman, T. O., Rosmalen, J. G. M., & Hanssen, D. J. C. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.111665 · Cited by 12 · cited 1× · see citing works
“95 Innovative treatment models from the UK and Norway to improve access to psychological therapies for patients with anxiety and depression, could also bene fi t patients with persistent physical symptoms.”
Self-citationJones, A. S. K., Harding, S., Seaton, N., Hudson, J. L., Duff, A., Wroe, A. L., Singh, H., Norton, S., Picariello, F., & Moss-Morris, R. E. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2024.107658 · Cited by 11 · cited 1× · see citing works
“99,100 These applications usually focus on education and self-help interventions and aim to improve quality of life and reduce somatic symptoms.”
Improving care for patients with functional disorders in Denmark
Brostrøm, S. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2018.11.003 · Cited by 10 · cited 1× · see citing works
“…and Germany) or functional somatic disorders (e.g., Danish regional centres for functional somatic disorders) where different healthcare professionals work within multidisciplinary teams, 91 while in other European countries there is currently no specialised care for persistent physical symptoms.”
Barends, H., Dekker, J., van Dessel, N. C., Twisk, J. W. R., van der Horst, H. E., & van der Wouden, J. C. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111343 · Cited by 10 · cited 1× · see citing works
“59 Social stressors and cultural factors, 60 such as negative encounters with healthcare professionals or employers, and general population prejudice, also negatively affect symptom courses.”
Schulz, A., Larra, M. F., Vögele, C., Kölsch, M., & Schächinger, H. (2023) · Biological Psychology · doi:10.1016/j.biopsycho.2023.108690 · Cited by 10 · see citing works
Maurer, M. E., Dardess, P., & Rouse, T. B. (2019) · Organizational behaviour in health care · doi:10.1007/978-3-030-14101-1_5 · Cited by 9 · see citing works
The burden of persistent symptom diagnoses in primary care patients: a cross-sectional study
Chaabouni, A., Houwen, J., Grewer, G., Liebau, M., Akkermans, R., van Boven, K., Walraven, I., Schers, H., & Hartman, T. O. (2024) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2023.2293930 · Cited by 9 · cited 1× · see citing works
“22 This Personal View highlights the progress made in recent years in the management of persistent physical symptoms, while also outlining unmet needs in care and research from an overarching perspective across symptoms and medical specialties.”
Self-citationPersonality factors and cognitive functioning in patients with somatic symptom and related disorders
de Vroege, L., Jong, J. E. W.-D., Videler, A. C., & Kop, W. J. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111067 · Cited by 8 · see citing works
Self-citationvan Gils, A., Tak, L. M., Sattel, H. C., & Rosmalen, J. G. M. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.725546 · Cited by 7 · see citing works
Self-citationChristensen, O. R., Hedegaard, L., Rask, M. T., Clemensen, J., Frostholm, L., & Rosendal, M. (2023) · JMIR Human Factors · doi:10.2196/42572 · Cited by 7 · cited 2× · see citing works
“80,98 Particularly in medically under-served rural areas or European countries with fewer care capacities, the allocation of limited resources could be optimised by providing patients with digital health applications, where complex topics can be conveyed, with or without direct healthcare…”
Self-citationNagel, C., Chloe, Q., & Burton, C. D. (2024) · BMC Medical Education · doi:10.1186/s12909-024-05610-z · Cited by 7 · see citing works
Self-citationWerge, T. M., Fang, F., Aspelund, T., Didriksen, M., Sævarsdóttir, K. S., Valdimarsdóttir, U. A., Jakobsdóttir, J., Magnúsdóttir, I., Lovik, A., Johnson, S. U., et al. (2025) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/tydd-9162 · Cited by 6 · see citing works
Regnath, F., Biersack, K., Jäger, N., Glasauer, S., & Lehnen, N. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1294702 · Cited by 5 · see citing works
Self-citationRaasthøj, I., Jarbøl, D. E., Rasmussen, S., Wehberg, S., Sætre, L. M. S., Rosendal, M., & Carstensen, T. B. W. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.111832 · Cited by 5 · cited 1× · see citing works
“Population-based cohorts point towards an increase in symptom burden, 115 which may have been accelerated by the COVID-19 pandemic in recent years.”
Self-citationPsychosomatic Medicine in Germany
Scheidt, C. E. (2017) · International journal of body, mind and culture · doi:10.22122/ijbmc.v4i2.95 · Cited by 3 · cited 1× · see citing works
“89 While it may not always be possible or necessary to manage persistent physical symptoms within independent specialties, collaboration across various disciplines, with each contributing their strengths, improves outcomes.”
Fried, D. A., McAndrew, L. M., Helmer, D. A., Markowitz, S. M., & Quigley, K. S. (2020) · BMC Family Practice · doi:10.1186/s12875-020-01193-y · Cited by 3 · see citing works
Symptom diagnoses in primary care: Which symptoms persist?
Chaabouni, A., Houwen, J., Peters, H. J. G., van Boven, K., Schers, H., & Hartman, T. O. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110836 · Cited by 3 · see citing works
Self-citationTreatment Provided in Children and Adolescents with Functional Seizures—A Danish Nationwide Cohort
Sørensen, N. B., Nielsen, R. E., Christensen, A.-E., Kjeldsen, M. K., Rask, C. U., Christensen, J., & Hansen, A. S. (2023) · Children · doi:10.3390/children10071218 · Cited by 2 · cited 1× · see citing works
“83 Although existing guidelines are unanimous in these treatment steps, 84 – 86 European countries differ signi fi - cantly in guideline availability, fi nancing of evidence-based treatments, and availability of specialised care structures for persistent physical symptoms.”
Self-citationChaabouni, A., Houwen, J., Akkermans, R., van Boven, K., Walraven, I., Blanker, M. H., Schers, H., & Hartman, T. O. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.111859 · Cited by 2 · see citing works
Self-citation
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Research works printed but not linked: 1
- [117]Institute of Medicine (US) Committee on Pain, Disability, and Chronic Illness Behavior Pain as a public health challenge 2011 National Academies Press (US)
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Selinheimo, S., Vuokko, A., Lappalainen, P., Keinonen, K., Sainio, M., Lappalainen, R., & Paunio, T. (2025) · BMC Psychology · doi:10.1186/s40359-025-02549-8 · Cited by 8 · see citing works
“A recent review calls for action in health-care systems in Europe to create care standards that are adaptable for different subgroups of PPS [71].”
Self-citationBallering, A., Lucassen, P. L., van Tol, D. G., Goubert, L., & Bracke, P. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.118232 · Cited by 4 · see citing works
Lebrun, H., Zablith, I., Stone, J., Vasilache, A., Gouraud, C., Ancellin-Geay, A., Kachaner, A., Ranque, B., Lemogne, C., & Pitron, V. (2025) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2025.112197 · Cited by 4 · see citing works
Self-citationCan the pain field learn from the functional somatic disorder field?
Gormsen, L. K., Fink, P., Butler, S. H., Henningsen, P., Loeser, J. D., Rief, W., & Finnerup, N. B. (2025) · Pain · doi:10.1097/j.pain.0000000000003733 · Cited by 3 · see citing works
Self-citationBravo, R. G., León-Herrera, S., Guisado‐Clavero, M., Larrondo, I. G., Wostmann, X., Wössner, N., Vinker, S., Ferla, F. V. L., Üçüncü, E. K., Tsigarovski, G., et al. (2025) · European Journal of General Practice · doi:10.1080/13814788.2025.2535618 · Cited by 3 · see citing works
Klein, E. M., Kruse, J., Löwe, B., Brähler, E., Lahmann, C., Witthöft, M., & Krakau, L. (2025) · Annals of Medicine · doi:10.1080/07853890.2025.2578726 · Cited by 3 · see citing works
“Persistent somatic symptoms are a core feature of numerous medical conditions [8], are common in mental disorders, such as depression and anxiety [2,5,9], and represent a core diagnostic criterion for Bodily Distress Disorder (BDD) as defined in ICD-11, as well as for Somatic Symptom Disorder in…”
Self-citationCui, Y. (2025) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2025.05.006 · Cited by 3 · see citing works
Hybelius, J., Hammarberg, S. A. W., Salomonsson, S., Wachtler, C., Epstein, M., Olsson, A., Strand, E., Winter, L. S., Åkerlund, T., Björkander, D., et al. (2025) · Psychological Medicine · doi:10.1017/s0033291725101244 · Cited by 2 · see citing works
Occlusal Dysesthesia: Identifying Knowledge Gaps to Advance Clinical Care
Esmat, S. A., He, H., & Cioffi, I. (2026) · Journal of Oral Rehabilitation · doi:10.1111/joor.70224 · Cited by 2 · see citing works
Awakening the sense of the possible: the Symptoms Clinic as liminal affective technology
Greco, M., Deary, V., Fryer, K., Sanders, T., & Burton, C. D. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.118395 · Cited by 2 · see citing works
Self-citationRoyeck, S., Meß, C., Weigel, A., Löwe, B., Toussaint, A. C., Schramm, C., Mora, M. C. S., Huber, T. B., Zeidler, C., Witte, F., et al. (2025) · Dermatology and Therapy · doi:10.1007/s13555-025-01539-3 · Cited by 2 · see citing works
“Supple-mental psychological interventions (e.g. stress coping interventions) may be beneficial in reducing psychological distress and improving overall QoL and to establish a patient-centred, holistic approach [13, 14, 16, 40].”
Self-citationMaroti, D., Ljungdahl, M., Petersen, H., Rööst, M., Falkenström, F., & Lilliengren, P. (2025) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001424 · Cited by 2 · see citing works
Canazei, M., Hüfner, K., Sperner‐Unterweger, B., Lampe, A., Weninger, J., Staggl, S., Dresen, V., & Weiss, E. M. (2025) · General Psychiatry · doi:10.1136/gpsych-2025-102357 · Cited by 1 · see citing works
Self-citationDahlberg, A. O., Aase, A., Reiso, H., Quarsten, H., Øines, Ø., & Midgard, R. (2025) · BMC Infectious Diseases · doi:10.1186/s12879-025-12182-w · Cited by 1 · see citing works
Development of the pruritus-associated stress scale: a cross-sectional pilot study
Royeck, S., Papathanassiou, J. S., Weigel, A., Kindt, N., Löwe, B., Meß, C., Zeidler, C., Witte, F., Agelopoulos, K., Wiegmann, H., et al. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1683259 · Cited by 1 · see citing works
Self-citationConcepts of psychosomatic disorders
Kavalchuk, A. N., & Шут, С. А. (2026) · Health and Ecology Issues · doi:10.51523/2708-6011.2025-22-4-01 · Cited by 1 · see citing works
Associations of generalized and social anxiety with somatic symptoms in Japanese university students
Iwasaki, S., Deguchi, Y., & Inoue, K. (2026) · Psychiatry Research · doi:10.1016/j.psychres.2026.117026 · Cited by 1 · see citing works
Vuokko, A., Immonen, M., Lappalainen, P., Keinonen, K., Sainio, M., Lappalainen, R., Paunio, T., & Selinheimo, S. (2026) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-026-10400-z
Self-citationThe silent struggle: how chronic hip pain shapes adolescent lives
Hernandez, E. J., Yasin, A., & Messer, K. (2025) · Baylor University Medical Center Proceedings · doi:10.1080/08998280.2025.2456407
Persistent Physical Symptoms—Healthcare Workers’ Experiences of Current Models of Care
Dismore, L. L., Thursby, S., Dovey‐Pearce, G., Goff, I., Ferguson, D., Tomson, D., & Swainston, K. (2025) · Psychology International · doi:10.3390/psycholint7010024
“…of PPS, and biopsychosocial models should be integrated into the education of healthcare professionals (Scope et al., 2021; Thursby et al., 2024; Toussaint et al., 2025), for example, the use of consultation-based interventions with mind–body explanations in conjunction with a PPS diagnosis…”
InfluentialDar, M. A., Amin, R., Bashir, N., Ahmad, O., & Sani, S. (2025) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20251299
Kowalski, J., Löwe, B., Schramm, C., Braun, F., Rillig, F., & Uhlenbusch, N. (2025) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001403
Self-citationRoyeck, S., Papathanassiou, J. S., Weigel, A., Kindt, N., Löwe, B., Meß, C., Zeidler, C., Witte, F., Agelopoulos, K., Wiegmann, H., et al. (2025) · medRxiv · doi:10.1101/2025.08.08.25333283
“Addressing psychological comorbidities may contribute to improved pruritus outcomes (14).”
Self-citationStrahl, A., Maehder, K., Toussaint, A. C., Hasenbank, N., Schramm, C., Lohse, A. W., Mora, M. C. S., Huber, T. B., Schneider, S. W., Ständer, S., et al. (2025) · medRxiv · doi:10.1101/2025.09.03.25334991
Self-citationThe FHJ debate: The NHS is failing to provide services for patients with symptom-based disorders
Burton, C. D., & Ellis, B. M. (2025) · Future Healthcare Journal · doi:10.1016/j.fhj.2025.100482
Self-citationContinuous nursing for postoperative quality of life in gastric cancer: A randomized trial
Liu, X., & Jiang, Y. (2026) · Psycho-Oncologie · doi:10.18282/po4636
Zhao, F., Yang, Q., Sun, Y., Zhao, M., Song, H., Ge, J., & Peng, S. (2026) · BMC Psychology · doi:10.1186/s40359-026-04245-7
“…medicine toward a biopsychosocial model, the complexity of PSS has become increasingly evident-it may present as either a single symptom or multiple symptom clusters, and may also meet the diagnostic criteria for functional disorders such as fibromyalgia and irritable bowel syndrome [2, 5–7].”
Zhou, N., Gu, Y., Liu, J., Zhang, L., Chen, L., Lu, Y., & Peng, T. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1756120
“It is particularly important to emphasize that when physical symptoms and psychological burden coexist, they may produce an amplifying “1 + 1 > 2” effect (36, 37).”
Erschens, R. S., Zipfel, S., Bentele, M., Adam, S. H., Schröpel, C., Heitmann, H., Binneböse, M., Zimmermann‐Schlegel, V., Reichert, J., Rometsch, C., et al. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1774114
Self-citationTowards a unified paradigm: chronic pain and functional somatic disorders
Montero, A. A. (2026) · Pain · doi:10.1097/j.pain.0000000000003941
Dhir-Hewitt, E., Newlands, F., Shafran, R., Stephenson, T. J., Richards‐Belle, A., Dalrymple, E., Chalder, T., Ford, T. J., Fox‐Smith, L., Heyman, I., et al. (2026) · BMC Public Health · doi:10.1186/s12889-026-27520-z
“Ongoing trials, service developments (integrating physical and mental health [36]) and service evaluations are crucial to establish best practice for managing persisting PCC in CYP.”
Jiang, B., Liao, Q.-Y., Yang, X.-P., & Chu, Y.-H. (2026) · Medicine · doi:10.1097/md.0000000000049431
Lewis, H., Burton, L.-J., Morton, K., Wray, F., Kelley, R., Radford, K., & Guthrie, E. (2026) · Disability and Rehabilitation · doi:10.1080/09638288.2026.2679886
Selinheimo, S., Vuokko, A., Lappalainen, P., Keinonen, K., Tolvanen, A. J., Lappalainen, R. I., Sainio, M., & Paunio, T. (2026) · International Journal of Behavioral Medicine · doi:10.1007/s12529-026-10477-z
Self-citationÄng, N. H., Särnholm, J., Andersson, G., Johansson, P., & Mourad, G. (2026) · BMC Psychology · doi:10.1186/s40359-026-05179-w
“It also involves helping patients develop explanations that validate bodily experience without reducing symptoms to either purely biomedical pathology or purely psychological causes [26].”
Dietsche, S., Weeren, F., Meinlschmidt, G., Toussaint, A. C., Cicic, N., Baenteli, I., Frick, A., Karpf, C., Studer, A., Wyss, K., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-10402391/v1
Self-citationKustra-Mulder, A., Liebau, M., Grewer, G., Rosmalen, J. G. M., Cosci, F., Rymaszewska, J., Löwe, B., & Weigel, A. (2026) · BMJ Public Health · doi:10.1136/bmjph-2025-004470
Self-citationSuvardhan, V. V. S. (2026) · Annals of Indian Psychiatry · doi:10.4103/aip.aip_270_26
Emerging insights into the physical health burden of personality disorders
Filipčić, I. Š., Filipčić, I., Čulina, I. J., Marčinko, D., & Jakšić, N. (2026) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000001110
Ribeiro, M. D., Giguère, C., & Cailhol, L. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1726738
“Although psycho-therapeutic approaches are often prioritized in mental health care, physical health is frequently overlooked, which may contribute to worse health outcomes (54, 55).”
Problématique de la prise en charge des troubles fonctionnels
Cathébras, P. J., & Goutte, J. (2026) · EMC - Traité de médecine AKOS · doi:10.1016/s1634-6939(26)50927-x
van Boven, K., Lucassen, P. L., Hartman, T. O., & den Bergh, O. V. (2026) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2026.2731974
“Primary care is fundamentally concerned with symptoms rather than established disease, and the relationship between symptoms and pathology is rarely proportional [1,3,4].”
InfluentialSelf-citationMoral‐Epistemic Dilemmas: The Case of Gender in Medical Diagnosis
Barnes, E. (2026) · Philosophical Perspectives · doi:10.1111/phpe.70005
Schwientek, A.-K., Braun, J., Baumer, A. M., Yasenok, V., Петрашенко, В. О., Kaufmann, M., Frei, A., Rüegger, S., Ballouz, T., Loboda, A., et al. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1922204
- Authors
- Toussaint, A., Weigel, A., Löwe, B., Blanch, J., Bogaerts, K., Boye, B., Burton, C., Cosci, F., Engelmann, P., Fink, P., Fischer, S., Frisch, S., Frostholm, L., Gormsen, L. K., Greco, M., Kallesoe, K. H., Hartman, T. O., Hechler, T., Hennemann, S., Henningsen, P., Hüfner, K., Hüsing, P., Ronel, J., von Känel, R., Kenedi, C. A., Köteles, F., Kohlmann, S., Kop, W. J., Lehnen, N., Levenson, J., Löwe, B., Maehder, K., Martin, A., Pieh, C., Pitron, V., Rask, C. U., Rief, W., Rosendal, M., Rosmalen, J., Rymaszewska, J., Sainio, M., Salzmann, S., Schaefert, R., Selinheimo, S., Shedden-Mora, M., Stone, J., Tak, L., Toussaint, A., Uhlenbusch, N., Van den Bergh, O., de Vroege, L., Weigel, A., Werneke, U., & Witthöft, M.
- ORCID
- Venue
- The Lancet Regional Health - Europe
- Publisher
- Elsevier BV
- Published
- 2025-01
- Volume
- 48
- Pages
- 101140
- ISSN
- 2666-7762 (ISSN-L)
- PMC
- PMC11629243
- OpenAlex
- W4404721348
- Cited by
- 44
- References
- 118
- Citations by year
- 2026: 23 · 2025: 21
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Regional Health - Europe (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Document Server@UHasselt (UHasselt) (submittedVersion, cc-by-nc-nd)
- Alexandria (UniSG) (University of St.Gallen) (submittedVersion)
- Florence Research (University of Florence) (submittedVersion, cc-by-nc-nd)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by-nc-nd)
- Funders
- Aarhus Universitet
- Aarhus Universitetshospital
- Philipps-Universität Marburg
- Virginia Commonwealth University
- Bergische Universität Wuppertal
- Universitätsspital Basel
- National Institute for Health and Care Research (15/136/07)
- European Commission (HORIZON2020, 956673)
- University of Bath
- Deutsche Forschungsgemeinschaft (RU 5211)
- Rijksuniversiteit Groningen
- Radboud Universiteit
- Università degli Studi di Firenze
- Westfälische Wilhelms-Universität Münster
- Technische Universität München
- Universitat de Barcelona
- Universität Zürich
- Universiteit van Tilburg
- Universitätsspital Zürich
- Universiteit Hasselt
- Eötvös Loránd Tudományegyetem
- Horizon 2020 Framework Programme (956673)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Keywords
- persistent physical symptoms, somatic symptoms, functional somatic syndromes, biopsychosocial model, symptom perception, healthcare policy, clinical management, stigma, interdisciplinary collaboration, research funding, European healthcare
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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