Functional Somatic Disorders in Individuals With a History of Sexual Assault 2025 Jacobsen et al

[Andy]

Key Points
Question Is sexual assault a risk factor for the development of functional somatic disorder (FSD) over a 5-year period?

Findings In this large cohort study of 4229 adults in Copenhagen, Denmark, sexual assault was associated with an increased risk of developing FSD, with symptoms affecting multiple body systems. The possible consequences of sexual assault extend across multiple organ systems, reflecting multiorgan involvement rather than confinement of symptoms to 1 organ system.

Meaning These findings suggest that sexual assault is associated with the risk of FSD, with a high prevalence of symptoms across organ systems, emphasizing the need for clinical awareness and preventive interventions.


Abstract
Importance An increasing number of sexual assaults (SAs) are reported. Prior studies show that SA is associated with functional somatic disorder (FSD).

Objective To investigate whether SA is associated with the development of incident FSD, including 3 functional somatic syndromes (FSSs), chronic widespread pain (CWP), irritable bowel syndrome (IBS), and chronic fatigue (CF), over 5 years.

Design, Setting, and Participants A large prospective cohort study was conducted based on 5-year follow-up data (2017-2020) from the Danish Study of Functional Disorders (DanFunD). Incident FSD cases were identified through symptom questionnaires and diagnostic interviews among the population-based cohort aged 18 to 72 years from the western greater Copenhagen area. Completion of baseline SA measures and follow-up assessments was required for eligibility. Data analysis was conducted between January and September 2024.

Exposures SA was assessed at baseline via 2 items from the self-reported Cumulative Lifetime Adversity Measure, dichotomized into exposed and nonexposed.

Main outcomes and measures Incident FSD cases were defined using standardized criteria for single-organ and multiorgan FSD, CWP, IBS, and CF. Risk ratios (RRs) for FSD outcomes were estimated using generalized linear models adjusted for sex, emotional distress, life adversity or trauma, subjective social status, somatic comorbidities, neuroticism, health anxiety, perceived stress, and self-efficacy.

Results Among the 4229 adults (53.9% women; median age, 56 [IQR, 47-64] years) from the DanFunD cohort, SA was associated with incident FSD (RR, 1.69; 95% CI, 1.17-2.44), single-organ FSD (RR, 1.65; 95% CI, 1.14-2.38), multiorgan FSD (RR, 6.47; 95% CI, 1.93-21.75), FSS (RR, 1.54; 95% CI, 1.14-2.07), and CWP (RR, 1.89; 95% CI, 1.11-3.23), while findings with IBS (RR, 1.60; 95% CI, 0.81-3.16) and CF (RR, 1.47; 95% CI, 0.89-2.42) were not significant. Overall, those who reported exposure to SA experienced a significantly higher frequency of incident somatic symptoms than individuals not exposed to SA, including musculoskeletal, gastrointestinal, cardiopulmonary, and fatigue-related symptoms. Baseline emotional distress (eg, anxiety or depression) did not modify the findings for SA and FSD. Sensitivity analysis based on diagnostic interviews confirmed these results.

Conclusions and Relevance Findings of this cohort study suggest that SA may increase the risk of developing FSD, involving multiple body systems. Despite limitations from small case samples in some FSD subtypes, the pooled analysis underscores the high risk of FSD, emphasizing the critical need for further research and targeted interventions to address the long-term biopsychosocial consequences of SA.

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[Hoopoe]

Or maybe it is the other way around, that people who are in poor health are more likely to experience sexual assault because of the vulnerability that this represents. Predators pick on the weak and vulnerable.

Illness doesn't begin with a diagnosis and subtle symptoms can be present years before that.

The same is probably happening with reported stress preceding illness. That the person recalls a period of high stress before the appearance of the illness doesn't mean that stress caused the illness. It's just as plausible that an already existing subclinical illness was affecting the stress tolerance and ability to manage a fully life before the person was aware they had an illness.

 

[Utsikt]

As usual, correlation is interpreted as possible one-way causation in favour of the authors’s pet theories.

 

[rvallee]

Sensitivity analysis based on diagnostic interviews confirmed these results.

Uh, this is not how any of this works. Damn are they milking this DanFunD thing, they must be at over 20 papers and absolutely none of it is of any use whatsoever.

SA was associated with incident FSD (RR, 1.69; 95% CI, 1.17-2.44), single-organ FSD (RR, 1.65; 95% CI, 1.14-2.38), multiorgan FSD

Ignoring the silliness of single-organ and multi-organ functional whatever, what the hell is incident FSD even supposed to mean? I guess it must mean short and transitory? Not a single hit, as far as I can tell this is the first and only use of the term but I'm not really interested in spending more than a minute looking for it or at this purely egocentric 'study'.