Multiple somatic symptoms predict impaired health status in functional somatic syndromes

F. H. Creed*, B. Tomenson, C. Chew-Graham, G. J. MacFarlane, I. Davies, J. Jackson, A. Littlewood, J. McBeth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

47 Citations (Scopus)


Background: The relationship between functional somatic syndromes and multiple somatic symptoms is unclear. 

Purpose: We assessed whether the number of somatic symptoms is a predictor of health status in three functional somatic syndromes (FSS). 

Methods: In a population-based study of 990 UK adults we assessed chronic widespread pain (CWP), chronic fatigue (CF) and irritable bowel syndrome (IBS) by questionnaire and medical record data. We assessed health status (Short Form 12 and EQ-5D), number of somatic symptoms (Somatic Symptom Inventory) and anxiety/depression (Hospital Anxiety and Depression Scale) both at baseline and at follow-up 1 year later. 

Results: The proportion of people with an FSS who also have multiple somatic symptoms (52-55 %) was similar in the three functional syndromes. The presence of multiple somatic symptoms was associated with more impaired health status both at baseline and at follow-up. This finding was not explained by severity of FSS. In the absence of multiple somatic symptoms, the health status of the FSS was fair or good. In multiple regression analysis, the number of somatic symptoms, the presence of a functional syndrome (CWP or CF) and anxiety/depression were predictors of EQ-5D thermometer at follow-up after adjustment for confounders. 

Conclusions: Multiple somatic symptoms in people with an FSS are associated with impaired health status and this cannot be explained by more severe functional syndrome or the presence of anxiety and depression.

Original languageEnglish
Pages (from-to)194-205
Number of pages12
JournalInternational Journal of Behavioral Medicine
Issue number2
Early online date30 Aug 2012
Publication statusPublished - Jun 2013

Bibliographical note

We are grateful to the participants in the project and to the General Practitioners who facilitated it. The study was funded by the UK Medical Research Council. The UK MRC had no role in study design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.


  • Chronic fatigue
  • Chronic widespread pain
  • Functional somatic syndromes
  • Health status
  • Irritable bowel syndrome
  • Somatisation


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