title: Symptom perception in healthy menopausal women: Can we predict concordance between subjective and physiological measures of vasomotor symptoms?
abstract: OBJECTIVE
  Perception of physical symptoms is an important factor in medical help-seeking. We aimed to examine both physiological and subjective measures of a commonly reported physical symptom-vasomotor symptoms (hot flushes and night sweats; HF/NS), and to investigate factors that might influence symptom perception, that is, concordance, over-reporting, and under-reporting of symptoms in healthy menopausal women.
  
  
  METHODS
  One hundred and forty women completed questionnaires assessing depressed mood, anxiety, stress, somatic symptoms, beliefs about HF/NS, and somatic amplification. Subjective and objective (24-h sternal skin conductance) measurements of HF/NS were obtained to assess concordance.
  
  
  RESULTS
  Thirty-seven percent of HF/NS were concordant while 47 and 16 % were under-reported and over-reported, respectively. Depressed mood, anxiety, somatic symptoms, and negative beliefs about HF/NS were associated with (higher) concordance, (less) under-, or (more) over-reporting. Negative beliefs about night sweats and sleep were the strongest predictors of concordance, whereas additional somatic symptoms and smoking predicted over-reporting.
  
  
  CONCLUSIONS
  Just over one third of physiologically recorded HF/NS were perceived as hot flushes; under-reporting of symptoms was more common than over-reporting. Interestingly, women who were more accurate in detecting physiological HF/NS tended to report more psychological and somatic symptoms and negative beliefs about HF/NS. Both measures should be included as outcomes of clinical trials.
authors.affiliation: Department of Psychology, Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Evgenia
authors.initials: E
authors.lastname: Stefanopoulou
authors.forename: Myra S
authors.initials: MS
authors.lastname: Hunter
mesh_terms: D000368:Aged; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D019584:Hot Flashes / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D010465:Perception; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013546:Sweating