High somatic symptom burdens and functional gastrointestinal disorders

Area of Science:

• Gastroenterology
• Psychiatry
• Symptomology

Background:

• Functional gastrointestinal disorders (FGIDs) are frequently associated with unexplained, multi-system somatic symptoms, indicative of somatization.
• Somatization is a key feature in patients diagnosed with FGIDs.

Purpose of the Study:

• To determine if current somatic symptom burden (somatization state) or prior functional diagnoses (somatization trait) predict FGIDs in outpatients.
• To investigate if comorbid depression or anxiety disorders influence the predictive value of somatization measures for FGIDs.

Main Methods:

• A review of clinical data from 327 new referrals to an outpatient gastroenterology practice (187 with FGID, 140 with structural illness).
• Somatization state assessed via self-reported current symptoms; somatization trait assessed via prior functional diagnoses in medical history.
• Psychiatric comorbidity (depression/anxiety) extracted from chart review.

Main Results:

• FGID patients reported more somatization symptoms, had more somatization diagnoses, and higher likelihood of psychiatric comorbidity (P < .001).
• Logistic regression confirmed that somatization state, somatization trait, and psychiatric comorbidity independently predicted FGID likelihood (P < .05).
• The positive predictive value for FGID exceeded 0.95 when high somatization ratings coincided with psychiatric comorbidity.

Conclusions:

• Elevated somatic symptom burden or a history of functional diagnoses are robust predictors of FGIDs in gastrointestinal outpatients.
• The predictive pathway for FGIDs involves factors beyond just the relationship with affective disorders, suggesting independent mechanisms.