Lifestyle factors as predictors of incident functional somatic disorder. Five-year follow-up of The DanFunD study

Abstract

Aims:

To assess whether lifestyle factors, including sleep pattern, are predictors for the development of functional somatic disorder (FSD).

Methods:

A population-based prospective cohort of 9656 men and women aged 18–76 years was established in 2011–2015 and invited for re-examination in 2017–2020, when 5738 participated. Median follow-up period was 65 months. Participants filled in validated questionnaires on lifestyle, sleep pattern and various delimitations of FSD, which were operationalized using two different approaches: bodily distress syndrome (BDS) and functional somatic syndromes (FSS) (i.e. chronic fatigue, chronic widespread pain (CWP), irritable bowel, and multiple chemical sensitivity (MCS)). Baseline lifestyle and sleep pattern in relation to incidence of BDS and FSS (chronic fatigue, CWP, irritable bowel, MCS) was analysed by logistic regressions, adjusted for age, sex and subjective social status.

Results:

Inferior sleep quality at baseline predicted both incidence of BDS and all FSS delimitations except MCS. Smoking, alcohol intake, and low physical activity, but not diet, were predictors for the development of BDS. No uniform pattern was observed for the FSS. Smoking predicted development of chronic fatigue, CWP and irritable bowel, but not MCS. Alcohol and food quality only influenced the development of chronic fatigue whereas low physical activity only influenced the development of chronic fatigue and CWP.

Conclusions:

Lifestyle factors and sleep pattern seem to be predictors for some delimitations of FSD, but the importance of the various lifestyle factors is different for the different delimitations. The study shows the importance of analysing the various FSSs separately.

Keywords

Functional somatic disorder lifestyle sleep pattern epidemiology incidence

Get full access to this article

View all access options for this article.

References

Burton

Fink

Henningsen

, et al.; EURONET-SOMA Group. Functional somatic disorders: Discussion paper for a new common classification for research and clinical use. BMC Med 2020;18:34.

Creed

. Review article: The incidence and risk factors for irritable bowel syndrome in population-based studies. Aliment Pharmacol Ther 2019;50:507-16.

Creed

. A review of the incidence and risk factors for fibromyalgia and chronic widespread pain in population-based studies. Pain 2020;161:1169-76.

Harvey

Wadsworth

Wessely

, et al. Etiology of chronic fatigue syndrome: Testing popular hypotheses using a national birth cohort study. Psychosom Med 2008;70:488-95.

Creed

. The risk factors for self-reported fibromyalgia with and without multiple somatic symptoms: The Lifelines cohort study. J Psychosom Res 2022;155:110745.

Chen

Muo

Kao

, et al. Increased risk of new-onset fibromyalgia among chronic osteomyelitis patients: Evidence from a Taiwan cohort study. J Pain 2017;18:222-7.

Andorsen

Ahmed

Emaus

, et al. A prospective cohort study on risk factors of musculoskeletal complaints (pain and/or stiffness) in a general population. The Tromso study. PLoS One 2017;12:e0181417.

Kay

Jorgensen

Jensen

. The epidemiology of irritable bowel syndrome in a random population: Prevalence, incidence, natural history and risk factors. J Intern Med 1994;236:23-30.

Uhlig

Sand

Nilsen

, et al. Insomnia and risk of chronic musculoskeletal complaints: Longitudinal data from the HUNT study, Norway. BMC Musculoskelet Disord 2018;19:128.

10.

Aili

Andersson

Bremander

, et al. Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5- and 18-year perspective. BMC Musculoskelet Disord 2018;19:390.

11.

Petersen

Schroder

Jorgensen

, et al. Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD. Sci Rep 2020;10:3273.

12.

Bjerregaard

Petersen

Skovbjerg

, et al. Physiological health and physical performance in multiple chemical sensitivity-described in the general population. Int J Environ Res Public Health 2022;19:9039.

13.

Wessely

Nimnuan

Sharpe

. Functional somatic syndromes: One or many? Lancet 1999;354:936-9.

14.

Dantoft

Ebstrup

Linneberg

, et al. Cohort description: The Danish study of Functional Disorders. Clin Epidemiol 2017; 9:127-39.

15.

Jorgensen

Dantoft

Weinreich Petersen

, et al. Examine the public health impacts of functional somatic disorders using the DanFunD study. Scand J Public Health 2022;50:988-94.

16.

Petersen

Schroder

Jorgensen

, et al. Prevalence of functional somatic syndromes and bodily distress syndrome in the Danish population: The DanFunD study. Scand J Public Health 2020;48: 567-76.

17.

Budtz-Lilly

Fink

Ornbol

, et al. A new questionnaire to identify bodily distress in primary care: The ‘BDS checklist’. J Psychosom Res 2015;78:536-45.

18.

Kay

Jorgensen

. Redefining abdominal syndromes. Results of a population-based study. Scand J Gastroenterol 1996;31:469-75.

19.

Chalder

Berelowitz

Pawlikowska

, et al. Development of a fatigue scale. J Psychosom Res 1993;37:147-53.

20.

Wolfe

Smythe

Yunus

, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33:160-72.

21.

White

Harth

Speechley

, et al. Testing an instrument to screen for fibromyalgia syndrome in general population studies: The London Fibromyalgia Epidemiology Study Screening Questionnaire. J Rheumatol 1999;26:880-4.

22.

Bartha

Baumzweiger

Buscher

, et al. Multiple chemical sensitivity: A 1999 consensus. Arch Environ Health 1999;54:147-9.

23.

Lacour

Zunder

Schmidtke

, et al. Multiple chemical sensitivity syndrome (MCS) – suggestions for an extension of the U.S. MCS-case definition. Int J Hyg Environ Health 2005;208:141-51.

24.

Dantoft

Nordin

Andersson

, et al. Multiple chemical sensitivity described in the Danish general population: Cohort characteristics and the importance of screening for functional somatic syndrome comorbidity – The DanFunD study. PLoS One 2021;16:e0246461.

25.

Toft

Kristoffersen

Lau

, et al. The Dietary Quality Score: Validation and association with cardiovascular risk factors: The Inter99 study. Eur J Clin Nutr 2007;61:270-8.

26.

Singh-Manoux

Adler

Marmot

. Subjective social status: Its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 2003;56:1321-33.

27.

Harrell

Jr.

Regression modeling strategies: With applications to linear models, logistic regression, and survival analysis. New York: Springer, 2001.

28.

Choi

Knutsen

Oda

, et al. The association between incident self-reported fibromyalgia and nonpsychiatric factors: 25-years follow-up of the Adventist Health Study. J Pain 2010;11:994-1003.

29.

Vandenkerkhof

Macdonald

Jones

, et al. Diet, lifestyle and chronic widespread pain: Results from the 1958 British Birth Cohort Study. Pain Res Manag 2011;16:87-92.

30.

Bendayan

Cooper

Muthuri

. Lifetime cigarette smoking and chronic widespread and regional pain in later adulthood: Evidence from the 1946 British birth cohort study. BMJ Open 2018;8:e021896.

31.

Bergman

Herrstrom

Jacobsson

, et al. Chronic widespread pain: A three year followup of pain distribution and risk factors. J Rheumatol 2002;29:818-25.

32.

McBeth

Lacey

Wilkie

. Predictors of new-onset widespread pain in older adults: Results from a population-based prospective cohort study in the UK. Arthritis Rheumatol 2014;66:757-67.

33.

Mundal

Grawe

Bjorngaard

, et al. Psychosocial factors and risk of chronic widespread pain: An 11-year follow-up study – the HUNT study. Pain 2014;155:1555-61.

34.

Kvalheim

Sandven

Hagen

, et al. Smoking as a risk factor for chronic musculoskeletal complaints is influenced by age. The HUNT study. Pain 2013;154:1073-9.

35.

Monden

Rosmalen

JGM

Wardenaar

, et al. Predictors of new onsets of irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia: The lifelines study. Psychol Med 2022;52:112-20.

36.

Collin

Bakken

Nazareth

, et al. Trends in the incidence of chronic fatigue syndrome and fibromyalgia in the UK, 2001–2013: A Clinical Practice Research Datalink study. J R Soc Med 2017;110:231-44.

37.

Elma

Yilmaz

Deliens

, et al. Chronic musculoskeletal pain and nutrition: Where are we and where are we heading? PM R 2020;12:1268-78.

38.

Kitselaar

van der Vaart

Perschl

, et al. Predictors of persistent somatic symptoms in the general population: A systematic review of cohort studies. Psychosom Med 2023;85:71-8.

39.

Petersen

Carstensen

TBW

Wellnitz

, et al. Neuroticism, perceived stress, adverse life events and self-efficacy as predictors of the development of functional somatic disorders: Longitudinal population-based study (DanFunD). BJPsych Open 2024;10:e34.

40.

Swendsen

Conway

Degenhardt

, et al. Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity Survey. Addiction 2010;105:1117-28.

41.

Stults-Kolehmainen

Sinha

. The effects of stress on physical activity and exercise. Sports Med 2014;44:81-121.

42.

Bremner

Moazzami

Wittbrodt

, et al. Diet, stress and mental health. Nutrients 2020;12:2428.

43.

Kim

Dimsdale

. The effect of psychosocial stress on sleep: A review of polysomnographic evidence. Behav Sleep Med 2007;5:256-78.

44.

Leijon

Wahlstrom

Mulder

. Prevalence of self-reported neck-shoulder-arm pain and concurrent low back pain or psychological distress: Time-trends in a general population, 1990–2006. Spine (Phila Pa 1976) 2009;34:1863-8.

45.

Pawlikowska

Chalder

Hirsch

, et al. Population based study of fatigue and psychological distress. BMJ 1994;308:763-6.

46.

Bergmann

Rehm

Klipstein-Grobusch

, et al. The association of pattern of lifetime alcohol use and cause of death in the European prospective investigation into cancer and nutrition (EPIC) study. Int J Epidemiol 2013;42:1772-90.

47.

Rinninella

Tohumcu

Raoul

, et al. The role of diet in shaping human gut microbiota. Best Pract Res Clin Gastroenterol 2023;62-63:101828.

48.

Varesi

Deumer

Ananth

, et al. The emerging role of gut microbiota in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): Current evidence and potential therapeutic applications. J Clin Med 2021;10:5077.

49.

Schovsbo

Dantoft

Thuesen

, et al. Social position and functional somatic disorders: The DanFunD study. Scand J Public Health 2023;51:225-32.

50.

Petersen

Ornbol

Dantoft

, et al. Assessment of functional somatic disorders in epidemiological research: Self-report questionnaires versus diagnostic interviews. J Psychosom Res 2021;146:110491.