Predictors of Persistent Somatic Symptoms in the General Population: A systematic review of cohort studies 2022 Kitselaar et al

Abstract

Objective
Up to 10% of the general population experiences persistent somatic symptoms (PSS). Numerous studies in a variety of health domains are dedicated to identifying factors that are associated with PSS onset. The present study aimed to provide an overview of predictors for PSS onset in the general population and the related health domains.

Methods
A systematic search was performed identifying longitudinal cohort studies that examined factors associated with PSS onset in the general population. Included studies measured potential predictors before PSS onset and were categorized according to the dynamic biopsychosocial model. Four levels of evidence were discerned for predictors, based on the number of studies and percentage of consistent findings.

Results
In the 154 articles eligible for analysis, 27 PSS-subtypes were studied, with primary focus on fibromyalgia (25.0%) and irritable bowel syndrome (23.3%). Of the >250 predictors of PSS onset, 46 were investigated more than once and showed consistent results. Strong evidence identifies biological (e.g., infections, body weight-related metrics), psychological (e.g., sleep problems, psychopathology), interpersonal (life events, childhood/interpersonal stress), contextual (employment), and health behavioral (health care utilization) predictors.

Conclusions
The results provide strong evidence for factors from all dynamic biopsychosocial domains, although interpersonal and health behavioral factors are relatively under investigated. Thus, evidence suggests that reduction of predictors of PSS onset to a specific factor/domain may be too restrictive. There is no evidence that this differs per PSS-subtype. Exploring all domains and measuring common factors across subtypes is essential to improve the clinical course of PSS.

Paywall, https://journals.lww.com/psychosoma...of_Persistent_Somatic_Symptoms_in_the.71.aspx

 

The idea of studying those vastly disparate issues into a huge mix is absurd. Imagine trying to find everything common between species of birds, some rocks, plant fossils, the rains in Africa, some turds that may or may not be wood sticks and what appears to be part of a clay pot. I'm sure it's possible to find some common features, and it would be completely useless.

Especially when you find that common features of illness include: illness and healthcare utilization, then somehow make it about other possible factors because those factors have to be constantly promoted like religious dogma.

This damn psychosocial ideology is probably the worst thing to have happened to medicine. It basically crippled the profession's ability to learn and do science, made all the principles and aims of medicine essentially moot.

 

I beg to differ.

 

I wonder if the biggest predictor of persistent somatic symptoms is the beliefs of the assessing physician, in that labelling the symptoms as somatic is likely to reflect the physician’s belief systems as much as any clinical reality and that label is likely to block any appropriate treatment if that could have been an option or any appropriate management, both risking perpetuation and/or worsening of symptoms, or even in some cases preventable death.

[added - if that is the case I am proposing important psychosocial factors, the psychological relation to the clinicians belief systems and the social relating to the fact that the patients are stuck with such clinicians. Which again leads to the issue of what percentage of such patients just give up on the medical system or significantly edit what information they provide when forced to interact with it.]

 

Absolutely wild that this pseudoscience can get away with what essentially consists of: everything affects this, but especially those things we have completely obsessed over for decades at the exclusion of everything else.

It's everything. But especially those things. That's how you can hand-wave with generalizations while claiming to be specific about it. But that this garbage is taken seriously is horrifying for what it suggests about other complete nonsense is used to make life and death decisions out there.