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Abstract

Background and aim:

It is generally accepted that functional somatic disorders (FSDs) are a product of biological, psychological, and social factors. Social position might be part of this complex, but the literature on this issue is currently heterogeneous and inconsistent. The aim of the present study was – in a population-based cohort – to test the hypothesis that lower social position would be associated with higher a risk of FSD.

Method:

The association between social position and FSD was examined in a cross-sectional study with various measures of social position (education as measured by vocational training; employment; cohabitation; subjective social status) and delimitations of FSD (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, bodily distress syndrome, and symptom profiles). The associations were analyzed using logistic regressions to calculate odds ratios and 95% confidence intervals. Each social measure was analyzed independently and was adjusted for age and sex.

Results:

Lower levels of vocational training, being unemployed, and living alone were associated with higher risk of FSD, regardless of the FSD delimitation. There was also a significant negative association between subjective evaluated social status and FSD. The associations remained after multiple adjustments, and seemed to be strongest for the more severe FSD-types.

Conclusions:

Lower social position is associated with higher risk of FSD, especially the more severe FSD delimitations, which might constitute an especially vulnerable group. However, the mechanisms behind the relations remain unknown.

Keywords

Social position education employment cohabitation subjective social status functional somatic disorders functional somatic syndromes bodily distress syndrome DanFunD epidemiology

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References

Burton

Fink

Henningsen

, et al. Functional somatic disorders: discussion paper for a new common classification for research and clinical use. BMC Med 2020;18(1): 34.

Petersen

Schröder

Jørgensen

, et al. Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD. Sci Rep 2020;10(1):3273.

Fink

Schröder

. One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. J Psychosom Res 2010;68(5):415–26.

Petersen

Schröder

Jørgensen

, et al. The unifying diagnostic construct of bodily distress syndrome (BDS) was confirmed in the general population. J Psychosom Res 2020;128:109868.

Budtz-Lilly

Fink

Ørnbøl

, et al. A new questionnaire to identify bodily distress in primary care: the “BDS checklist.” J Psychosom Res 2015;78(6):536–45.

Petersen

Schröder

Eliasen

, et al. Three different approaches to delimitation of functional somatic disorders: DanFunD. J Psychosom Res. Epub ahead of print 27 March 2021. DOI: 10.1016/j.jpsychores.2021.110475.

Budtz-Lilly

Schröder

Rask

, et al. Bodily distress syndrome: a new diagnosis for functional disorders in primary care? Clinical presentation, diagnosis, and management. BMC Fam Pract 2015;16(1):1–10.

Tak

Rosmalen

JGM

. Dysfunction of stress responsive systems as a risk factor for functional somatic syndromes. J Psychosom Res 2010;68(5):461–8.

Galobardes

Shaw

Lawlor

, et al. Indicators of socioeconomic position (part 1). J Epidemiol Community Health 2006;60(1):7–12.

10.

Holt-Lunstad

Smith

Baker

, et al. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci 2015;10(2):227–37.

11.

Lahelma

Martikainen

Laaksonen

, et al. Pathways between socioeconomic determinants of health. J Epidemiol Community Health 2004;58(4):327–32.

12.

Lovell

Ford

. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepato 2012;10(7):712–21.

13.

Collin

Bakken

Nazareth

, et al. Trends in the incidence of chronic fatigue syndrome and fibromyalgia in the UK, 2001–2013: a Clinical Practice Research Datalink study. J R Soc Med 2017;110(6):231–44.

14.

McBeth

Tomenson

Chew-Graham

, et al. Common and unique associated factors for medically unexplained chronic widespread pain and chronic fatigue. J Psychosom Res 2015;79(6):484–91.

15.

Fuller-Thomson

Mehta

Sulman

. Long-term parental unemployment in childhood and subsequent chronic fatigue syndrome. ISRN Family Med 2013;2013:978250.

16.

Schauer

Grabe

Ittermann

, et al. Irritable bowel syndrome, mental health, and quality of life: data from a population-based survey in Germany (SHIP-Trend-0). Neurogastroenterol Motil 2019;31(3):e13511.

17.

Fitzcharles

Rampakakis

Ste-Marie

, et al. The association of socioeconomic status and symptom severity in persons with fibromyalgia. J Rheumatol 2014;41(7):1398–404.

18.

Bhui

Dinos

Ashby

, et al. Chronic fatigue syndrome in an ethnically diverse population: the influence of psychosocial adversity and physical inactivity. BMC Med 2011;9:26.

19.

Dinos

Khoshaba

Ashby

, et al. A systematic review of chronic fatigue, its syndromes and ethnicity: prevalence, severity, co-morbidity and coping. Int J Epidemiol 2009;38(6):1554–70.

20.

Budtz-Lilly

Vestergaard

Fink

, et al. Patient characteristics and frequency of bodily distress syndrome in primary care: a cross-sectional study. Br J Gen Pract 2015;65(638):e617–23.

21.

Creed

Davies

Jackson

, et al. The epidemiology of multiple somatic symptoms. J Psychosom Res 2012;72(4):311–17.

22.

Dantoft

Ebstrup

Linneberg

, et al. Cohort description: the Danish study of functional disorders. Clin Epidemiol 2017;9:127–39.

23.

Singh-Manoux

Adler

Marmot

. Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 2003;56(6):1321–33.

24.

Eliasen

Schröder

Fink

, et al. A step towards a new delimitation of functional somatic syndromes: a latent class analysis of symptoms in a population-based cohort study. J Psychosom Res 2018;108:102–17.

25.

Kay

Jorgensen

. Redefining abdominal syndromes. Results of a population-based study. Scand J Gastroenterol 1996;31(5):469–75.

26.

Wolfe

Smythe

Yunus

, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33(2):160–72.

27.

White

Harth

Speechley

, et al. Testing an instrument to screen for fibromyalgia syndrome in general population studies: the London Fibromyalgia Epidemiology Study Screening Questionnaire. J Rheumatol 1999;26(4):880–4.

28.

Chalder

Berelowitz

Pawlikowska

, et al. Development of a fatigue scale. J Psychosom Res 1993;37(2):147–53

29.

Demakakos

Nazroo

Breeze

, et al. Socioeconomic status and health: the role of subjective social status. Soc Sci Med 2008;67(2):330–40.

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Social position and functional somatic disorders: The DanFunD study

Abstract

Background and aim:

Method:

Results:

Conclusions:

Keywords

Get full access to this article

References

Supplementary Material