Functional somatic symptoms and psychological states: an electronic diary study

Area of Science:

• Psychosomatic Medicine
• Clinical Psychology
• Medical Sociology

Background:

• Functional physical symptoms are common in patients with persistent medically unexplained symptoms.
• Existing research shows inconsistent links between physical symptoms and psychological states.
• Previous diary studies were limited in scope, examining single symptom and psychological variable pairs.

Purpose of the Study:

• To investigate the associations between functional physical symptoms and psychological states.
• To explore these links in a sample of patients with persistent medically unexplained symptoms.
• To address limitations of prior research by examining multiple symptoms and psychological variables concurrently.

Main Methods:

• Twenty-six patients with at least three functional physical symptoms participated.
• Twice-daily electronic diary self-report measures of symptoms, fatigue, anxiety, stress, mood, and symptom concern were collected over 12 weeks.
• Linear mixed effects models were used to analyze associations at both diary entry and individual levels.

Main Results:

• Diary ratings of anxiety and stress were low, despite high baseline depression and anxiety scores.
• Mood and symptom concern showed stronger associations with functional physical symptoms compared to anxiety or stress.
• Fatigue and musculoskeletal pain exhibited less individual variation in symptom experience compared to other symptoms.

Conclusions:

• Self-reported mood and symptom concern are key psychological correlates of functional physical symptoms.
• The weak correlation between symptoms and psychological states may contribute to patients' rejection of psychosomatic explanations.
• Findings highlight the importance of considering mood and symptom concern in understanding and managing functional somatic symptoms.