Somatic symptom burden and distress in post COVID-19 and [PPS]: Evidence from combined SSD-12 and PHQ-15 factor analysis 2026 Liira et al

[Andy]

Highlights​

• SSD-12 and PHQ-15 showed similar distributions in LC and PPS cohorts.
• About half of patients met the combined SSD-12 and PHQ-15 clinical threshold.
• High symptom burden linked to poorer quality of life and lower resilience.
• Factor analysis identified two emotional and two somatic symptom factors.
• LC and PPS shared a largely overlapping symptom structure.

Abstract​

Background and Aim​

Post COVID-19 condition (PCC) and persistent physical symptoms (PPS) may involve overlapping symptom presentations. We examined whether symptom-related dimensions differ or overlap between PCC and functional somatic disorders by comparing Somatic Symptom Disorder–B Criteria Scale (SSD-12; cognitive-affective distress) and the Patient Health Questionnaire-15 (PHQ-15; somatic symptom burden), and by performing a joint factor analysis of their items.

Methods​

Two cohorts at Helsinki University Hospital were analysed: the Sympa cohort (2020–2024), comprising patients with PPS, and the Long Covid (LC) cohort (2021−2023), including patients with PCC and age- and sex-matched controls.

Results​

The study included 557 patients with PPS, 433 with PCC, and 197 controls; two-thirds of patients in both cohorts were female. Patients showed markedly higher somatic symptom burden than controls, with 52.2% of patients with PPS and 48.0% of those with PCC exceeding the combined SSD-12 and PHQ-15 threshold indicating concurrent high somatic symptom burden and symptom-related distress. Joint factor analysis revealed a four-factor structure: one dominant cognitive-affective distress factor; a narrower persistence–worry factor; and two symptom clusters reflecting pain/gastrointestinal and autonomic–neurological symptoms. Participants above the threshold had poorer quality of life, lower resilience, and more comorbidities and symptoms across cohorts (all p < 0.001).

Conclusions​

Approximately half of rehabilitation clinic patients with PPS or PCC exhibited high somatic symptom burden and symptom-related distress. Despite differing clinical entry points, the two cohorts showed broadly similar symptom-related dimensions. High symptom-related distress identifies a subgroup with greater impairment who may benefit from targeted rehabilitation approaches.

Open access

 

[Alinda]

People with a chronic or long lasting condition have chronic symptoms and feel (and "act"!) ill.
How surprising!!

(Do they not already consider long covid part of PPS? Or is this just a paper to argue that since they both cause someone to feel ill, it shall be considered the same thing?)

 

[Peter T]

Is this yet another paper finding that the worse someone is the worse they are?

Why do they not include an arm that has an uncontested biomedical (ie non psychogenic) condition with comparable levels of disability as a control? Though there is a question as to whether believers in a psychogenic foundation for functional disorders would accept any condition as being purely non psychogenic.

 

[rvallee]

High symptom burden linked to poorer quality of life and lower resilience

How is that a highlight? This is literally, really actually literally, "more water means wetter". Except they prefer to argue it as "ackshually, wetter causes there to be more water". Do they truly have no understanding whatsoever of what symptoms are?!

This is all completely circular. They ask about symptoms. They compare to a fake construct that asks about symptoms. And they call it a match? I can't accept that no one involves doesn't understand this is pure nonsense. So why are they doing it?

Joint factor analysis revealed a four-factor structure: one dominant cognitive-affective distress factor; a narrower persistence–worry factor; and two symptom clusters reflecting pain/gastrointestinal and autonomic–neurological symptoms. Participants above the threshold had poorer quality of life, lower resilience, and more comorbidities and symptoms across cohorts (all p < 0.001).

This is completely useless. None of this is real, they're confusing reality with shadows on the walls they make themselves. Those questionnaires should be banned, they have no plausible positive use and massively negative ones.