Multiple physical symptoms and individual characteristics – A cross-sectional study of the general population, 2020, Rasmussen et al

Andy

Andy

Retired committee member
Highlights
• BDS is fairly common in the general adult population with a prevalence of 15.5%.
• The prevalence of BDS is highest among younger women and also higher in ethnic minorities.
• BDS individuals have low socioeconomic status, poor self-rated health and impaired functional capacity.
• BDS is positively associated with health risk behavior and increased healthcare and medication use.

Abstract
Objective
Multiple physical symptoms not attributable to known organic disease are common in all medical fields and associated with major personal and social consequences. This study investigated multiple physical symptoms according to the construct of bodily distress syndrome (BDS) and associated individual characteristics in the general adult population.

Methods
A nationwide, population-based study of 100,000 randomly selected individuals aged 20 years and older, conducted in 2012. A web-based questionnaire formed the basis of the study and was combined with Danish national registry data on socioeconomic factors and medication and healthcare use.

Results
49,706 individuals completed the questionnaire. After exclusion of women indicating pregnancy, respondents reporting chronic disease and respondents over 65 years of age, 23,331 remained for analysis. Of these 23,331 individuals, 15.5% fulfilled the criteria for BDS. BDS positives were more often younger (20–40 years) and female. Self-rated health and self-reported functional capacity were impaired among these individuals. Fulfilling the BDS criteria was significantly associated with current or former smoking, overweight and obesity, low educational level and income, and unemployment. Moreover, individuals with BDS were more often from ethnic minorities and had higher use of healthcare and medication.

Conclusion
Multiple physical symptoms, as captured by the concept of BDS, are common in the general adult population, especially among younger women. Fulfilling the BDS criteria is associated with substantial negative impact on self-perceived health and socioeconomic parameters. Fulfilling BDS criteria is positively associated with health risk behaviors (smoking, overweight and obesity) and higher use of healthcare and medication.
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Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0022399919308700
Sci hub, https://sci-hub.se/10.1016/j.jpsychores.2020.109941
 
BDS is fairly common in the general adult population with a prevalence of 15.5%.
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Wow that's a lot of unmet medical needs. Someone really should do something about this. No wonder the alternative medicine industry is so enormous and thriving. I'm sure insulting over a billion people will go swimmingly over credibility and trust in medical expertise. No possibility of blowback, this time. Unlike every other time. This time it's definitely right. Unlike every other time. "You're sick because you're poor and stupid, and you're probably poor because you're stupid (since you're likely poor because you're sick and you're sick because you're stupid)", is exactly the message you want to communicate as medical professionals in this trying time of the post-truth era, plagued by disinformation and ambiguity.

The rational reaction from this should be that these people are out of their damn minds and that the BDS construct is complete nonsense. Or people could just go with the magical thinking that always fails, I guess that's another perfectly rational approach to public health.
Fulfilling the BDS criteria was significantly associated with current or former smoking, overweight and obesity
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All of which are known to be detrimental to health. And, no, it's not the "behavior" that is harmful but the actual doing of those things, the actual inhalation of smoke and the actual physiological impact of extra weight. Although I'm not entirely sure it's worth blaming bodily weight twice over but OK.
low educational level and income, and unemployment
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Those tend to be consequences of poor health. Medicine with zero common sense and a complete rejection of Occam's razor looks posititively dumb.
Multiple physical symptoms not attributable to known organic disease are common in all medical fields
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I love that the basis of this is a self-referencing tautology. It has been somehow decided by some that most chronic symptoms should be asserted to not only have no attributable cause but that there will never, ever, be one. Then turn around and say that the people experiencing those symptoms are delusional by the same people who have decided that they know that no cause will ever be found.

Literally the process of labeling a box, putting stuff in that box and noting that the stuff in the labeled box was found in the box after having been put there on purpose. This should lead to a failing grade in entry-level courses, it's blatantly unscientific. Seriously this may as well be official: this stuff here, the MUS/BPS/FND thing, is the worst and most mediocre failure in the history of medicine because there simply is no valid justification anymore for this much aggressive willful ignorance. Seriously impressive stuff, there's tough competition to be the worst here and you did it!
 
Fulfilling the BDS criteria was significantly associated with current or former smoking, overweight and obesity
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Bolding mine.

Former smoking, really. How long is former? A month? A year? A decade? 25 years?

I am a former smoker. I decided to see how long I could go without smoking over a quarter of a century ago. I was talking about it with a GP who was curious about how I quit & stayed off 'em. According to her, if you stay off them for a decade or more, the effects are reversed.

So, some precision please.
 
The smoking bit reminds me of something I read recently. The language used is annoying (magic) but according to them the science says that lung damage from smoking is reversed over time (as IW points out). So former smoking would seem to be there simply out of the researchers own belief system -- which brings the other things into doubt as to their scientific basis IMO.

https://www.bbc.com/news/health-51279355
 
Jonathan Edwards said:
Some the are but I doubt that established emphysema is.
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Yes, I think she meant if you haven't already developed a smoking related disease.

I smoked for 10 years. In at least the last 5 years I had a 20 a day habit and on a rough day that could easily go up as high as 30. She reckoned that once I hit the 10 year mark off the cigs (& presumably not frequenting.smoke filled environments) the effects should be completely reversed.
 
Sarah94 said:
Funny, I thought it was supposed to be us overachievers who developed MUS.
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This is where IAPT trained psychologists can use their skills. If you are an overachiever they will be able to use their knowledge to see that your ME is due to overachieving. If you are a poorly educated unemployed layabout then they can use their skills to deduce that this is why you have ME. It is all about personalised assessment, nothing to do with those silly old published trials that treated everyone the same. I can assure you this is the case, one of them explained it to me.
 
Since nobody is a perfectly average person without any life stressors it is always possible to create a narrative of this or that character flaw or event or behaviour causing psychogenic illness. Or just claim that the effects of the illness are actually its cause (like they do in IBS where they claim that thoughts and fears about IBS causes the illness).
 
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