The association between quality of life and psychological flexibility, depressive, anxiety or insomnia symptoms in patients with persistent indoor environment-related symptoms or chronic fatigue
Open accessAbstract
BACKGROUND: Persistent physical symptoms (PPS) can significantly impair health-related quality of life (HRQoL) and are often accompanied by psychiatric comorbidity. Psychological flexibility (PF), characterized by the ability to adapt functionally and congruently to diverse situations based on personal values, may play a crucial role in determining HRQoL. This study aims to examine the associations between symptoms of depression, anxiety or insomnia or PF and HRQoL among individuals with PPS associated with (i) the indoor environment (IE), (ii) chronic fatigue, or (iii) both. METHODS: We utilized the baseline data (n = 103) from a randomized controlled trial focused on improving the HRQoL of individuals (mean age 46.1, SD 7.8, 86% women) experiencing PPS associated with IE or chronic fatigue. Self-report questionnaires were administered to evaluate symptoms of depression, anxiety, insomnia, and dimensions of PF, including acceptance, cognitive fusion, and thought suppression. The primary outcome was HRQoL, assessed using a 15D questionnaire. The association between symptoms, PF dimensions, and HRQoL was examined using Pearson's correlation and ANCOVA. RESULTS: Symptoms of depression, anxiety, and insomnia were negatively associated with HRQoL (p <.001) across all participants. Among individuals with PPS associated with IE, higher PF was significantly associated with higher HRQoL. No association was found between PF and HRQoL in those with chronic fatigue-associated PPS or both conditions. CONCLUSIONS: PF associated with positive outcomes in HRQoL in individuals with PPS associated with the indoor environment, but not in those with chronic fatigue. Further research on the differences between these groups is warranted to enhance treatment targeting. TRIAL REGISTRATION: Clinicaltrials.gov NCT04532827 (registered 26.08.2020).
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The CF group showed poorer functioning and reported more symptoms and reduced quality of life compared to the IE-related PPS group.
“However, the CF group showed poorer functioning and, consistent with our earlier findings from the same dataset, reported more symptoms and reduced quality of life compared to the IE-related PPS group [41].”
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- Authors
- Selinheimo, S., Vuokko, A., Lappalainen, P., Keinonen, K., Sainio, M., Lappalainen, R., & Paunio, T.
- Affiliations
- Finnish Institute of Occupational Health (FI)
- University of Jyväskylä (FI)
- Helsinki University Hospital (FI)
- University of Helsinki (FI)
- Corresponding author
- Selinheimo, Sanna
- ORCID
- Venue
- BMC Psychology
- Published
- 2025-03-11
- Volume
- 13
- Issue
- 1
- Pages
- 229-229
- ISSN
- 2050-7283 (ISSN-L)
- PMC
- PMC11900652
- OpenAlex
- W4408335605
- Cited by
- 8
- References
- 70
- Citations by year
- 2026: 6 · 2025: 2
- FWCI
- 9.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Jyväskylä University Digital Archive (University of Jyväskylä) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Social Insurance Institution of Finland (75/331/2019)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Keywords
- psychological flexibility, health-related quality of life, persistent physical symptoms, chronic fatigue, depression, anxiety, insomnia, acceptance, cognitive fusion, thought suppression, psychiatric comorbidity
- MeSH terms
- Adaptation, Psychological, Adult, Anxiety, Depression, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Fatigue Syndrome, Chronic
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