Functional Somatic Distress And Related Psychosocial Factors

ObjectivesTo understand the prevalence and the psychosocial features of functional somatic distress (FSS) and functional somatic disorders (FSD) in different kinds of populations of Hunan, China, and to explore the relationships between FSD and neurosis defined by the traditional concept.Methodsa. Instruments Psychosomatic symptom scale (57 psychological symptoms and 50 somatic symptoms) developed from the Symptom Checklist 90(SCL-90) and the Cornell Medical Index (CM). Revised Scale of Susceptibility to Stress (SUS). Stress Recept Scale (SRS). Social-demographic Questionnaire including some help-seeking behavioral items. Simplified Coping Style Questionnaire (CPS).b. Subjects Two healthy samples including 450 (441 cases come into statistics) software corporation employees and 304 medical students (301 cases come into statistics). 32 functional dyspepsia patients (FD), and 33 inpatients diagnosed as neuroses. 1,332 consecutive outpatients in different special clinics of the Third Xiangya Hospital of Central South University, Changsha, China were surveyed with a screen scale edited based on the symptom criteria of somatization disorders of CCMD-3 and the definition of functional disorders. 139 neurotic patients and 30 patients with somatoform disorders who were referred to the Department of Psychiatry were tested with MMPI (Chinese revised version).Resultsa. Employees and students had 15.2 12.4 and 15.61 11.82respectively in the 50 somatic symptoms of the scale, and there was no statistically significant difference between the two groups(p>0.05). Still no statistically significant differences were found in the frequencies of psychological and physical symptoms between the two groups (p>0.05).b. There were no statistically significant differences on the prevalence rates of FSS of different somatic systems between the two groups (p>0.05) except of sleep symptoms. In the normal group, the SCL-90 somatic symptoms average score of 7.3% of the subjects was above 2 (but 3 ) and that of 0.3% of the subjects was above 3.The rates of diferent severe degree of the symptom (i.e. any SCL-90 subscale average score >2 (but 3) and >3), in normal group were 33.2% when any average score >2(but 3) , and were 6.3% when any average score >3. There were no statistically significant differences between two groups (p>0.05) .c. The prevalent rates of somatic symptoms in normal group were 6.6% for males and 9.2% for females. There was no significant difference between male and female subjects in the total prevalence (p>0.05). However, female prevalence rates of five sense organ symptoms (student group), pain symptoms (employee group), and fatigue symptoms (employee group) were higher than that of male (p<0.05).d. Help-seeking behaviors (times of doctor visiting, medicine taking days, medical cost) had no statistically significant correlation with stress related variables and psychological symptoms in SCL-90, but some of them had statistically significant correlation with different groups, age, marital status and symptoms of pain, five sense organ, respiratory and somatic symptoms total scores (p<0.05).e. There were positive statistically significant correlations among somatic symptoms total scores and psychological symptoms total scores; and among FSS total score, each system somatic score and psychological symptoms total score, each SCL-90 subscale score, sick-felling score, SRS score, SUS score, CPS-negative (CPSN) score, and CPS-positive (CPSP) score (negative correlation), P<0.05.f. Different somatic symptom's Logistic regression equation had different psychosocial factors and psychological symptoms entered. Forexample, marriage, anxious, and sick-felling entered cardiovascular symptom's regression equation; gastrointesting equation has depression and sick-felling entered. As stress related variables, only SRS entered sleep, fatigue, and five organs equation.