Neurodevelopmental and personality traits of somatic symptom disorder: A cross-sectional study 2025 Shimizu et al

Abstract

Aim
Somatic symptom disorder (SSD) is prevalent in primary healthcare settings and is often challenging to diagnose and treat. This study examined the neurodevelopmental and personality traits of individuals with probable SSD.

Methods
This cross-sectional study utilized anonymous online surveys. In this study, individuals with a score of 23 or higher on the Somatic Symptom Disorder–B Criteria Scale (SSD-12) were defined as having probable SSD, and individuals with no somatic symptoms and who scored 0 were defined as the healthy control (HC) group. We compared groups regarding neurodevelopmental traits, personality traits, depression, and anxiety using self-report questionnaires and analysis of covariance. In addition, we examined the association between neurodevelopmental traits, emotional problems, and SSD in the probable SSD group using structural equation modeling.

Results
A total of 491 people with probable SSD and 532 age- and sex-matched HCs were analyzed. The scores for somatic symptom severity, depression, generalized anxiety, health anxiety, attention deficit/hyperactivity disorder traits, autism spectrum disorder traits, personality traits, and personality disorder traits showed significant differences between the probable SSD group and the HC group. In the probable SSD group, neurodevelopmental traits positively and directly affected emotional problems and SSD.

Conclusion
Most neurodevelopmental and personality traits were associated with probable SSD. When approaching patients suspected of having SSD, clinicians may consider not only somatic symptoms, but also neurodevelopmental traits, personality traits, depression, and anxiety.

Open access

 

I believe these are the questions of SSD-12. No wonder they correlate with anxiety etc.

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Q1_I think my somatic symptoms are due to a serious illness

Q2_I am very concerned about my health

Q3_My health concerns hinder me in daily life

Q4_I am convinced my symptoms are serious

Q5_My somatic symptoms make me anxious

Q6_My somatic symptoms keep me occupied most of the day

Q7_Other people tell me my somatic symptoms are not serious

Q8_I am afraid that my symptoms will never subside

Q9_My concerns about my symptoms will never disappear

Q10_I think physicians do not take my symptoms seriously

Q11_Because of my somatic symptoms I cannot concentrate properly on other things

Q12_I am worried that my somatic symptoms will continue in the future

Item scores range between 0 and 4 (0 = never, 1 = rarely, 2 = sometimes, 3 = often, 4 = very often)

 

They managed to get 34,000 fully filled out questionnaire respondents to something about this which seems huge given the lines about making sure there was informed consent by an online description of what it was about snd ticking it etc and the content

I don’t know if any SDD diagnosed stayed with people from this ?

interested that they used the questionnaire to filter down a guess of 10% probably having SSD from this

and about 500 (a third of that number) have the pain type of SSD that they wanted to narrow it to - interesting that this number is then 50% male as these psychosomatic things tend to target females indeed the bps marketing research papers for similar conditions often explicitly suggest to GPs ‘tend to be females’ etc

does the focus on them adding in ASD as one of their focus things they incorporated account for this gender ‘balance’ given historically higher ASD diagnosis in males ? (I don’t know what today is like in JApan re more women being diagnosed for ASD?)


Anyway I can’t help thinking as the bit missing from all their ‘tests’ is where they checked - or more precisely did nothing at all to check- whether people had undiagnosed biomedical explanations for their pain etc


Then went on to talk about how it’s unmarried poor people, unemployed and retired who finished their education before uni as over represented in those with SSD demographic ie most vulnerable and perhaps unlikely to have been medically checked out - I don’t know what costs are for it access to medical is in Japan bs demographics?

But then they are right they did use healthcare a lot more 332/481 using it once a month vs single figures for the control group

BUT the control group was apparently matched but not on any of the demographics above. Which seems strange what they thought they did match them on?

And did they match even people who had pain or any illness - so wouldn’t need to try and get medical care?

Could the increase be that they’ve selected people by their having something wrong with them that needed to be looked at - and the frequency be very explained by the combo of lower standing and higher issues like ASD or ADHD actually standing in the way of them getting treated or investigated properly?

how did that become SSD rather than a social and cultural issue potentially being flagged with the healthcare system until they’ve had independent experts with no conflicts of interest but who are keen to check them out properly making sure there really aren’t biomedical conditions or injuries being missed - perhaps with communication support from some ASD/ADHD advocates ?

 

I might have to score this with 4 points.

The rest of the questions are even intelletually offensive to me.