A population-based twin study of functional somatic syndromes
Open accessAbstract
Background: The mechanisms underlying the co-occurrence of the functional somatic syndromes are largely unknown. No empirical study has explicitly examined how genetic and environmental factors influence the co-morbidity of these syndromes. We aimed to examine how the co-morbidity of functional somatic syndromes is influenced by genetic and environmental factors that are in common to the syndromes. Method: A total of 31318 twins in the Swedish Twin Registry aged 41–64 years underwent screening interviews via a computer-assisted telephone system from 1998 to 2002. Four functional somatic syndromes (chronic widespread pain, chronic fatigue, irritable bowel syndrome, and recurrent headache) and two psychiatric disorders (major depression and generalized anxiety disorder) were assessed using structured questions based on standard criteria for each illness in a blinded manner. Results: Multivariate twin analyses revealed that a common pathway model with two latent traits that were shared by the six illnesses fit best to the women's data. One of the two latent traits loaded heavily on the psychiatric disorders, whereas the other trait loaded on all four of the functional somatic syndromes, particularly chronic widespread pain, but not on the psychiatric disorders. All illnesses except the psychiatric disorders were also affected by genetic influences that were specific to each. Conclusions: The co-occurrence of functional somatic syndromes in women can be best explained by affective and sensory components in common to all these syndromes, as well as by unique influences specific to each of them. The findings clearly suggest a complex view of the multifactorial pathogenesis of these illnesses.
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Up to 74% of individual differences in somatic symptoms are explained by genetic factors in twin studies.
“Up to 74% of individual differences in somatic symptoms are explained by genetic factors in twin studies (Kato et al., 2009; Kendler et al., 1992), which supports the co-occurrence of these somatic symptoms as a depression endophenotype.”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Kato et al., 2009
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- Authors
- Kato, K., Sullivan, P. F., Evengård, B., & Pedersen, N. L.
- Affiliations
- International University of Health and Welfare (JP)
- University of North Carolina at Chapel Hill (US)
- Karolinska University Hospital (SE)
- University of Southern California (US)
- Corresponding author
- Kato, K.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2008-06-26
- Volume
- 39
- Issue
- 3
- Pages
- 497-505
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC3947533
- OpenAlex
- W2140407256
- Cited by
- 237
- References
- 46
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 9 · 2023: 9 · 2022: 9 · 2021: 12 · 2020: 10 · 2019: 7 · 2018: 15 · 2017: 15 · 2016: 15 · 2015: 20 · 2014: 15 · 2013: 9 · 2012: 26
- FWCI
- 11.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- AstraZeneca
- Vetenskapsrådet
- National Institute of Neurological Disorders and Stroke (R01NS041483, R01NS041333, NS 041483)
- 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 › Epidemiology › Chronic Disease Management Strategies
- Keywords
- functional somatic syndromes, chronic widespread pain, chronic fatigue, irritable bowel syndrome, recurrent headache, major depressive disorder, generalized anxiety disorder, genetic factors, environmental influences, comorbidities, twin studies, Swedish Twin Registry, women, latent traits, pathogenesis
- MeSH terms
- Anxiety Disorders, Mental Disorders, Chronic Disease, Major Depressive Disorder, Diseases in Twins, Female, Fibromyalgia, Humans, Male, Middle Aged, Pain, Risk Factors, Sex Factors, Somatoform Disorders, Sweden, Twins, Dizygotic, Twins, Monozygotic, Fatigue Syndrome, Chronic, Comorbidity, Multivariate Analysis, Irritable Bowel Syndrome
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