Functional and internalizing disorders co-aggregate with cardiometabolic and immune-related diseases within families: ... 2025 Steen et al

Andy

Andy

Senior Member (Voting rights)
Full title: Functional and internalizing disorders co-aggregate with cardiometabolic and immune-related diseases within families: a population-based cohort study.

Abstract​

Background​

Functional disorders share familial risk with internalizing disorders such as generalized anxiety disorder and depression, and are comorbid with cardiometabolic and immune-related diseases. We investigated whether functional and internalizing disorders co-aggregate with these diseases in families to gain insight into the aetiology of functional and internalizing disorders.

Methods​

We included 166,774 subjects (aged 3–94), from the population-based Lifelines Cohort Study, a Dutch general population cohort. We defined cases for three functional disorders (myalgic encephalomyelitis/chronic fatigue syndrome; ME/CFS, fibromyalgia, and irritable bowel syndrome; IBS), two internalizing disorders (major depressive disorder; MDD and generalized anxiety disorder; GAD), cardiometabolic diseases (obesity, metabolic associated steatotic liver disease, type 2 diabetes, hypertension and cardiovascular disease) and immune-related diseases (composite measures of auto-immune disease and atopy). We used logistic regression to model the prevalence of these disorders in the general population and in participants with affected relatives. Using these prevalence estimates, we assessed familial co-aggregation with (1) recurrence risk ratios (λ<em>R</em>), and (2) familial correlations (r<em>f</em>).

Results​

All functional and internalizing disorders co-aggregated with immune-related diseases (λ<em>R</em> range 1.06–1.24). ME/CFS, FM, and MDD co-aggregated with most cardiometabolic diseases (λ<em>R</em> range 1.00–1.23). MDD, fibromyalgia, and ME/CFS showed similar familial correlation patterns with both disease groups (r<em>f</em> range 0.12–0.44), while patterns of IBS and GAD were more variable.

Conclusions​

Internalizing and functional disorders share familial risk with immune-related and cardiometabolic diseases. This suggests that risk factors relevant to immune-related and cardiometabolic diseases may also be relevant for FDs. Future studies should investigate such risk factors to identify novel treatment targets.

Open access
 
"Functional disorders (FDs) such as fibromyalgia (FM), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and irritable bowel syndrome (IBS) are characterized by somatic symptoms with poorly understood aetiology. These disorders are common, affecting up to 10% of individuals in European countries [1]. They significantly impact quality of life and functioning. Despite this, there is a lack of effective treatments, likely deriving from little insight into the mechanisms underlying the development of FDs.

Current etiological models suggest a complex interplay of biological, psychological, and social factors contributing to the development of FDs."

"We used the 1994 Centers for Disease Control and Prevention criteria [17] for ME/CFS "
 
Our findings suggest that the aetiology of FDs may include risk factors shared with common somatic diseases, which could be identified in future studies.
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They are edging closer and closer to understanding it - that FDs are themselves somatic diseases.

It’s also weird how they apparently accept that there are somatic diseases, because their FD framework clearly predicts that they should all be biopsychosocial!

Maybe it’s a bit taboo to call RA and MS psychosomatic?
 
Utsikt said:
They are edging closer and closer to understanding it - that FDs are themselves somatic diseases.

It’s also weird how they apparently accept that there are somatic diseases, because their FD framework clearly predicts that they should all be biopsychosocial!

Maybe it’s a bit taboo to call RA and MS psychosomatic?
Click to expand...
Oh, they tried, called it an "overlay of FND".
 
Functional disorders share familial risk with internalizing disorders such as generalized anxiety disorder and depression,​

So, after the GWAS results the relevance to us of the 'functional' label is...?

Functional disorders (FDs) such as fibromyalgia (FM), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and irritable bowel syndrome (IBS) are characterized by somatic symptoms with poorly understood aetiology.​
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How can it be definitively classified as a "functional disorder", and yet have a "poorly understood aetiology"?
 
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