title: Functional somatic syndromes: asking about exclusionary medical conditions results in decreased prevalence and overlap rates.
abstract: BACKGROUND
  The diagnosis of functional somatic syndromes (FSS) requires 1) presence of somatic symptoms, and 2) absence of medical conditions potentially accounting for these symptoms. Due to the limited feasibility of medical examinations, epidemiological research on FSS has neglected to assess the second criterion. Our objective was therefore to evaluate the implications of considering information on exclusionary medical conditions in epidemiological research on FSS.
  
  
  METHODS
  A survey among 3'054 students was conducted. We compared prevalence rates and overlap of 17 FSS obtained by: 1) a symptom-based strategy and 2) a symptom-and-exclusion-based strategy including information on exclusionary medical conditions.
  
  
  RESULTS
  The symptom-and-exclusion-based strategy led to a marked decrease in prevalence rates compared to the symptom-based strategy. Furthermore, it resulted in fewer individuals who were affected by multiple FSS.
  
  
  CONCLUSIONS
  Adding self-reported information on exclusionary medical conditions leads to a significant decrease in the prevalence and overlap of FSS. More rigorous approaches to studying FSS should be adopted.
authors.affiliation: Clinical Biopsychology, Department of Psychology, University of Marburg, Gutenbergstrasse 18, 35032 Marburg, Germany. susanne.fischer@uni-marburg.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Fischer
authors.forename: Urs M
authors.initials: UM
authors.lastname: Nater
mesh_terms: D000328:Adult; D004415:Dyspepsia / Q000453:epidemiology*; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology; D006801:Humans; D006985:Hyperventilation / Q000453:epidemiology* / Q000523:psychology; D043183:Irritable Bowel Syndrome / Q000453:epidemiology*; D008297:Male; D017699:Pelvic Pain / Q000453:epidemiology; D065446:Premenstrual Dysphoric Disorder / Q000453:epidemiology*; D011293:Premenstrual Syndrome / Q000453:epidemiology*; D015995:Prevalence; D057566:Self Report; D013334:Students; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology; D055815:Young Adult