Persistent physical symptoms after COVID-19 infection and the risk of Somatic Symptom Disorder 2023 Horn et al

Highlights

• Many patients with COVID-19 present with persistent symptoms after the acute phase.
• 10.4% of these patients were considered at risk of Somatic Symptom Disorder (SSD).
• Age, sex, and psychotraumatic symptoms were associated with the severity of SSD.
• Identification of SSD should incite clinicians to surpass the somatic/psychiatric dualism.

Abstract

Objective
Evidence shows that many patients with COVID-19 present persistent symptoms after the acute infection. Some patients may be at a high risk of developing Somatic Symptom Disorder (SSD), in which persistent symptoms are accompanied by excessive and disproportionate health-related thoughts, feelings and behaviors regarding these symptoms. This study assessed the frequency of persistent physical symptoms and SSD and their associated factors in patients with confirmed COVID-19.

Methods
We conducted a longitudinal retrospective study after the first two French lockdowns at the Lille University Hospital (France), including all patients with confirmed COVID-19. Persistent physical symptoms and excessive preoccupations for these symptoms were measured 8 to 10 months after the onset of COVID-19. The combination of the Patient Health Questionnaire-15 and the Somatic Symptom Disorder-B Criteria Scale was used to identify the individuals likely to present with SSD. Two linear regression models were performed to identify sociodemographic and medical risk factors of SSD.

Results
Among the 377 patients with a laboratory-confirmed diagnosis, 220 (58.4%) completed the questionnaires. Sixty-five percent of the 220 included patients required hospitalization, 53.6% presented at least one persistent physical symptom and 10.4% were considered to present SSD. Female sex, older age, infection during the second wave and having probable PTSD were significantly associated with the severity of SSD and SSD was associated with a significantly higher healthcare use.

Conclusions
The identification of SSD should encourage clinicians to move beyond the artificial somatic/psychiatric dualism and contribute to a better alliance based on multi-disciplinary care.

Open access, https://www.sciencedirect.com/science/article/pii/S0022399923000272

 

I went to a psychologist who diagnosed me with SSD (presumably my thoughts were excessive), or maybe he wanted to help me get disability. I didn't think it was very excessive. At the time I saw him, my health concerns were very reasonable as I had recently discovered ME. I was grieving, trying to get disability, and seeking a diagnosis (which I received 3 months later).

 

I wasn’t aware that the university hospital of Lille — in northern France, where most of the authors are based — had a psychosomatic approach to long Covid. So far, it had mostly been pushed by Profs Lemogne and Ranque from Paris. Sad to see.

 

It's so weird how obsessed medicine is with making relevance out of sex and age. There are nearly always differences between sexes in diseases so this means little but of course it's used to enforce the notion that women=hysterical, which is still the actual reasoning to this day. And by the very definition of linear time, everyone passes through the years so that if age is a factor it's only a circumstantial factor, it still applies to the whole population at one point or another. This is as much as risk factor as being alive is one.

But besides this nonsense, having defined SSD as having more than X symptoms, then grading a "severity" based on additional symptoms, of course you're going to find that sicker patients meet the circular definition, having invented it this way. This is exactly like describing how pressure a researcher applies on a scale makes it move more, and being genuinely oblivious to the fact that they are in fact influencing their own results, instead marveling that it proves them right. Just straight up absurd, this is intelligence without any reasoning whatsoever, pure rote memorization and nothing not found in the textbook is allowed to ever be thought.

Seriously this is clownish, it's bootstrapped evidence, it propels itself on its own force, which is impossible. It's as valid as a police detective mailing themselves anonymous evidence, using their own return address, and genuinely pretending it's an anonymous tip. You actually have to question the sanity of a system that assesses this nonsense and cannot see anything wrong with it.

This is the equivalent of "the more we press on the scale, the more weight it shows and that means the object is more massive":



They even notice that sicker individuals have more healthcare contacts. Which: freaking duh! How could it even make sense otherwise? This is literally what one expects out of sicker individuals. It's truly as if they have no model of real life, only the small clinically significant bits of data they exclusively use in a clinical setting. Imaginary models above reality itself.

I mean, what is wrong with these people?:

Many of the symptoms are neurological. Do they genuinely not understand that neurological symptoms will affect cognition and behavior? Seriously? Is this written by alien robots who have never lived in a human body?

The gist of this paper is: circular reasoning is circular.

 

The SSD-12 questionnaire is available in this paper. They ask about symptoms like dizziness, insomnia, chest pain, cognitive impairment, fatigue and shortness of breath. People with LC will score ludicrously high on this, and people with pre-existing or secondary mental conditions will rate high on mental symptoms too. It's absolutely unusable for evaluating health anxiety in pwLC. Oh, and health anxiety is understandable if you recently became disabled by an illness nobody understands.

 

There's a committee. Trudie Chalder chairs it.

 

I have no idea whether the two questionnaires are related (as this one is 9 questions, the one in this link is 15), however having read the followigg paper which includes Sharpe, Stone, Carson saying that the PHQ 15 doesn't identify people with unexplained symptoms better than chance I thought I'd do a quick google in case there were papers for which this reference might be relevant:

Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients - PubMed (nih.gov)

Conclusions: Self-rated symptom count scores should not be used to identify patients with symptoms unexplained by disease."

To discuss this paper, go to this thread:
Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a ... study of neurology outpatients, 2015, Carson, Sharpe

 

Taylor Swift?

 

Tortured poets department

 

And this is where SSD ends up a year later in the UK UK: Disability benefits (UC, ESA and PIP) - news and updates 2023 (including government plans to scrap the work capability assessment)