How many functional somatic syndromes?
Abstract
Objective Patients with medically unexplained symptoms are given diagnoses dependent upon the particular medical specialty consulted--irritable bowel syndrome in gastroenterology, fibromyalgia in rheumatology and others. The purpose of this paper is to establish whether these 13 different syndromes are discrete entities.Methods Consecutive new patients in seven outpatient clinics at two general hospitals were recruited. Patients completed questionnaires measuring symptoms and demographic data. Case notes were reviewed to ascertain whether the presenting symptoms were medically explained 3 months after the initial visit.Results Complete data were available for 550 subjects. With 37 unexplained symptoms included in the model, 30% of the total variance could be explained by one factor using unrotated principal component analysis. When the 13 identified functional syndromes were included, it was evident that functional syndromes could not be assumed to be independent. A two-factor model was the best fit for the present data after rotation.Conclusions This study suggests that the existence of distinct functional somatic syndromes (FSSynd) as defined clinically in medicine should be reconsidered.
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Patients frequently receive medical specialty-specific syndrome diagnoses such as fibromyalgia, chronic widespread pain, chronic fatigue syndrome, and irritable bowel syndrome.
“In the healthcare system, patients frequently receive medical specialty-specific syndrome diagnoses (FSS) such as fibromyalgia, chronic widespread pain, chronic fatigue syndrome, and irritable bowel syndrome [6,7].”
From Internet-delivered treatment for patients suffering from severe functional somatic disorders: Protocol for a randomized controlled trial (2023) · cites this paper as [7]
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- Authors
- Nimnuan, C., Rabe-Hesketh, S., Wessely, S., & Hotopf, M.
- Affiliations
- King's College London (GB)
- Corresponding author
- Hotopf, Matthew
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2001-10
- Volume
- 51
- Issue
- 4
- Pages
- 549-557
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2115163863
- Cited by
- 269
- References
- 51
- Citations by year
- 2026: 8 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 41 · 2020: 6 · 2019: 10 · 2018: 9 · 2017: 7 · 2016: 2 · 2015: 11 · 2014: 1 · 2013: 9 · 2012: 11
- FWCI
- 11.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- functional somatic syndromes, medically unexplained symptoms, irritable bowel syndrome, fibromyalgia, syndrome classification, factor structure, symptom heterogeneity
- MeSH terms
- Cross-Sectional Studies, Diagnosis, Differential, Female, Humans, London, Male, Medicine, Psychophysiologic Disorders, Somatoform Disorders, Specialization, Syndrome
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