Longitudinal association of mental-health problems with subsequent diagnosis of persistent somatic symptom disorders: 2026 Kitselaar et al

[Andy]

Full title: Longitudinal association of mental-health problems with subsequent diagnosis of persistent somatic symptom disorders: A large-scale registry-based observational study in primary care

Abstract​

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.

Open access

 

[Hoopoe]

Maybe the initial symptoms of these illnesses are misinterpreted as mental health problems.

I did have depression before the diagnosis of ME/CFS and it was the result of the illness in combination with a lack of recognition, lack of experience on how to manage it, mismatch between plans and capabilities, misunderstanding of the problem by others (ironically, as mental health problem).

In simple words: undiagnosed, unrecognised, recent onset of a disabling illness that is widely misunderstood is a recipe for depression. To treat the depression you need to treat the underlying cause. Calling it depression might even make the problem worse, by increasing the feeling of not being misunderstood, of a disconnect between what is happening and what others believe is happening, increasing the sensation of hopelessness via failed treatment approaches, and wrong approaches to management (reducing activity is seen as "giving up" and so on).

 

[rvallee]

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.

It's so well-known that those illnesses are routinely invalidly coded, the fact that this is framed in the context of one of the acronym pools of psychobehavioral labels says it all, so none of this is based on reality, and this will obviously not be happening because it's done on purpose, out of the belief that "somatic symptoms", aka symptoms, are mental illness, a failure that this paper repeats itself.

There is no excuse not to know this, but of course that's simply an extension of the same failures that lead to those illnesses being invalidly coded as routine practices in the first place.

A lot of severe diseases have presentations that can be, and are, mistaken for mental illness. This would equivalent to using this as some sort of exercise trying to pin those diseases, including many forms of cancer, as having a mental illness component, when the invalid attribution is simply just that, invalid. Medicine routinely uses its own mistakes to justify its new mistakes. This is something humans often do, but is rarely tolerated in other professions because someone has to pay the bill for it, and they'd rather not to. Here we pay the bill, in full. All of it, with our lives, and no one else even notices, especially the people who offload their "duties" onto the people they fail.

And this is especially egregious because this invalid coding is entirely a choice, to hide the existence and prevalence of illnesses they don't believe in, but then someone comes up with this idea where "hey, why don't we take this invalid coding and try to predict things with it?", when coding it correctly in the first place would achieve that better, faster and cheaper.

I'm so tired of having to constantly work around egos and failing systems and their bizarre ways just because they can't deal with reality and do everything they can do avoid dealing with it. Even though it does no such thing, they still deal with it, just in the worst possible ways with the worst possible outcomes for everyone.

 

[Utsikt]

MS patients’s health care usage starts increasing 14 years before their diagnosis, and the first category to rise is mental health. Maybe, just maybe, mental health labels are at best tentative.

 

[nataliezzz]

Maybe the initial symptoms of these illnesses are misinterpreted as mental health problems.

I did have depression before the diagnosis of ME/CFS and it was the result of the illness in combination with a lack of recognition, lack of experience on how to manage it, mismatch between plans and capabilities, misunderstanding of the problem by others (ironically, as mental health problem).

In simple words: undiagnosed, unrecognised, recent onset of a disabling illness that is widely misunderstood is a recipe for depression. To treat the depression you need to treat the underlying cause. Calling it depression might even make the problem worse, by increasing the feeling of not being misunderstood, of a disconnect between what is happening and what others believe is happening, increasing the sensation of hopelessness via failed treatment approaches, and wrong approaches to management (reducing activity is seen as "giving up" and so on).

I'm inclined to think that a lot of people with chronic depression, anxiety, insomnia, etc. who do not meet criteria for ME/CFS, fibromyalgia, etc. also do not have a true "mental health problem" in the sense that their illness is likely not primarily driven by psychological factors.