General hospital psychiatry · 2026
Longitudinal association of mental-health problems with subsequent diagnosis of persistent somatic symptom disorders: A large-scale registry-based observational study in primary care.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Kitselaar Willeke M, Hartmann Lea, Evers Andrea W M, Numans Mattijs E
Аннотация
BACKGROUND: Somatic symptoms of common persistent somatic symptom (PSS) syndromes like irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), and fibromyalgia (FM) are not fully attributed to well-established biomedical pathological processes. These syndromes are often under-recognized and diagnosis is often delayed. This study assessed the extent to which mental health problems precede the onset of IBS, CFS, and FM diagnoses using large-scale registry-based data from primary care settings.
METHOD: Data from 11,409 patients were anonymously extracted from primary care data-bases in the Netherlands. Cases (IBS, CFS, or FM) and non-cases were matched for age and sex using a 1:2 ratio. Associations with preceding mental health were available mental health-related registrations in the dataset (i.e., mental health-related ICPC-codes, referrals, and psychopharmaceuticals) registered prior to diagnosis. For predictive modeling, logistic LASSO regressions were applied.
RESULTS: A total of 27 variables were longitudinally associated with IBS, CFS or FM (IBS k = 25, CFS k = 10, and FM k = 20). Five variables were longitudinally associated with all three syndromes (i.e., anxiety, psychosis, addiction behavior, and concentration disorders had positive predictive value and mental health-related referrals had negative predictive value). The overall classification performance of the models was fair (AUCIBS = 0.77) to good (AUCCFS = 0.82, AUCFM = 0.88).
CONCLUSIONS: Findings indicate that mental health-related registrations in primary care are associated with, vary between, and can accurately predict IBS, CFS, and/or FM. Prediction rules derived from mental health-related registrations might be able to support GPs in identifying patients with PSS. Future studies should investigate whether distinct decision rules are needed for the different syndromes.
METHOD: Data from 11,409 patients were anonymously extracted from primary care data-bases in the Netherlands. Cases (IBS, CFS, or FM) and non-cases were matched for age and sex using a 1:2 ratio. Associations with preceding mental health were available mental health-related registrations in the dataset (i.e., mental health-related ICPC-codes, referrals, and psychopharmaceuticals) registered prior to diagnosis. For predictive modeling, logistic LASSO regressions were applied.
RESULTS: A total of 27 variables were longitudinally associated with IBS, CFS or FM (IBS k = 25, CFS k = 10, and FM k = 20). Five variables were longitudinally associated with all three syndromes (i.e., anxiety, psychosis, addiction behavior, and concentration disorders had positive predictive value and mental health-related referrals had negative predictive value). The overall classification performance of the models was fair (AUCIBS = 0.77) to good (AUCCFS = 0.82, AUCFM = 0.88).
CONCLUSIONS: Findings indicate that mental health-related registrations in primary care are associated with, vary between, and can accurately predict IBS, CFS, and/or FM. Prediction rules derived from mental health-related registrations might be able to support GPs in identifying patients with PSS. Future studies should investigate whether distinct decision rules are needed for the different syndromes.