Short report: Somatic symptoms and associated psycho-behavioural variables: The mediating role of loneliness

Previous research suggests that people with higher levels of somatic symptom burden report more loneliness, psychological symptom severity, depressive symptoms, and healthcare utilisation. Loneliness may be a link between somatic symptom burden and these psycho-behavioural variables. We proposed that loneliness is highest among participants with elevated somatic symptom burden and psychological symptom severity as in somatic symptom disorder (SSD). Furthermore, we proposed loneliness as a mediator of the relationships between somatic symptom burden (1) depression, (2) SSD psychological symptom severity, and (3) healthcare utilisation.

In a general population-based cross-sectional survey (N = 512, 76.8% female, age M = 34.93, SD = 14.6) we assessed somatic symptom burden and associated psycho-behavioural variables (e.g. B criteria symptoms of SSD, loneliness). Group differences were analysed using ANOVAs. Mediation analyses were conducted using PROCESS.

Participants with high somatic and psychological symptom burden (SSD group) reported the highest degree of loneliness. Loneliness partially accounted for the relationship between somatic symptom burden and (1) SSD psychological symptom severity (ab = 0.109; 95% CI: 0.048, 0.178) and (2) depression severity (ab = 0.120, 95% CI: 0.087, 0.158). However, loneliness did not mediate the relationship between somatic symptom burden and healthcare utilisation.

The present findings suggest that a high somatic symptom burden is associated with greater loneliness, which in turn can promote psychological symptom severity and depressive symptoms. In clinical practice, addressing loneliness may be essential to prevent further burden.