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Published on: November 30, 2016
Course and predictors of somatic symptom disorder in irritable bowel syndrome and ulcerative colitis: A longitudinal
Luisa Peters1, Anna Matysiak2, Sina Hübener2
1Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Background:
Longitudinal data on somatic symptom disorder (SSD) in ulcerative colitis (UC) and irritable bowel syndrome (IBS) are lacking. Understanding SSD trajectories and predictors in these conditions may clarify clinical relevance and guide psychological treatment decisions. This study examined the 12-month course and biopsychosocial predictors of interview-based SSD in patients with UC or IBS participating in a randomised controlled trial (RCT).
Methods:
Longitudinal data from an RCT targeting gastrointestinal symptom persistence was analysed. SSD was assessed using DSM-5-based structured interviews at baseline and 12 months. SSD Criteria A (presence of distressing somatic symptom(s)) and B (excessive symptom-related distress) were operationalised with the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Disorder - B Criteria Scale-12 (SSD-12), respectively. Further variables included gastrointestinal symptom severity, inflammatory markers, depression and gender, illness perceptions, and neuroticism. Logistic and linear regression models identified baseline predictors of SSD diagnosis and Criteria A and B at 12 months.
Results:
The sample included 213 patients (73.7% female; Mage = 40.5, SD = 13.98) with UC (n = 110) or IBS (n = 103). SSD frequency was 42.3% (95% CI: 35.2-49.3) at baseline and 15.5% (95% CI, 11.3-20.7) at follow-up. Interview-based SSD diagnosis at 12 months was predicted by baseline symptom-related distress, whereas gastrointestinal symptom severity, depression severity and gender showed no independent predictive value. Dimensionally assessed Criterion A was predicted by baseline somatic symptom severity and female gender, and Criterion B by symptom-related distress, somatic symptom severity, and negative illness perceptions, while gastrointestinal symptom severity and inflammatory markers added no predictive value.
Conclusion:
Structured interview-based SSD was prevalent in patients with UC or IBS at baseline and declined over time. Psychosocial rather than disease-related variables predicted SSD, highlighting modifiable targets for early detection and tailored interventions. Results should be interpreted cautiously due to the interventional study context, which may have influenced both baseline SSD frequency and change over time.
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