title: Somatic Symptoms: Prevalence, Co-Occurrence and Associations with Self-Perceived Health and Limitations Due To Physical Health - A Danish Population-Based Study.
abstract: A high number of somatic symptoms have been associated with poor health status and increased health care use. Previous studies focused on number of symptoms without considering the specific symptoms. The aim of the study was to investigate 1) the prevalence of 19 somatic symptoms, 2) the associations between the symptoms, and 3) the associations between the somatic symptoms, self-perceived health and limitations due to physical health accounting for the co-occurrence of symptoms. Information on 19 somatic symptoms, self-perceived health and limitations due to physical health was achieved from a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark in 2006/07. Chain graph models were used to transparently identify and describe the associations between symptoms, self-perceived health and limitations due to physical health. In total, 94.9% of the respondents were bothered by one or more of the 19 somatic symptoms. The symptoms were associated in a complex structure. Still, recognisable patterns were identified within organ systems/body parts. When accounting for symptom co-occurrence; dizziness, pain in legs, respiratory distress and tiredness were all strongly directly associated with both of the outcomes (γ>0.30). Chest pain was strongly associated with self-perceived health, and other musculoskeletal symptoms and urinary retention were strongly associated with limitations due to physical health. Other symptoms were either moderate or not statistically associated with the health status outcomes. Opposite, almost all the symptoms were strongly associated with the two outcomes when not accounting for symptom co-occurrence. In conclusion, we found that somatic symptoms were frequent and associated in a complex structure. The associations between symptoms and health status measures differed between the symptoms and depended on the co-occurrence of symptoms. This indicates an importance of considering both the specific symptoms and symptom co-occurrence in further symptom research instead of merely counting symptoms.
authors.affiliation: Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark.
authors.forename: Marie
authors.initials: M
authors.lastname: Eliasen
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Svend
authors.initials: S
authors.lastname: Kreiner
authors.affiliation: Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark.
authors.forename: Jeanette F
authors.initials: JF
authors.lastname: Ebstrup
authors.affiliation: Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark.|Mental Health Centre Copenhagen, The Capital Region of Denmark, Gentofte, Denmark.
authors.forename: Chalotte H
authors.initials: CH
authors.lastname: Poulsen
authors.affiliation: Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark.
authors.forename: Cathrine J
authors.initials: CJ
authors.lastname: Lau
authors.affiliation: Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark.
authors.forename: Sine
authors.initials: S
authors.lastname: Skovbjerg
authors.affiliation: Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Per K
authors.initials: PK
authors.lastname: Fink
authors.affiliation: Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark.|Department of Public Health, University of Copenhagen, Copenhagen, Denmark.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D015995:Prevalence; D012737:Sex Factors; D011795:Surveys and Questionnaires