Review Understanding General Somatic Symptom Burden: Insights from a Systematic Review of Factor Analyses Pertaining to [PHQ-15] and [SSS- 8] 2025 Axelsson+

[Andy]

Full title: Understanding General Somatic Symptom Burden: Insights from a Systematic Review of Factor Analyses Pertaining to the Patient Health Questionnaire 15 (PHQ- 15) and Somatic Symptom Scale 8 (SSS- 8)

Abstract

Background
Factor analyses have indicated that somatic symptom burden can be separated into local symptom domain factors (e.g., cardiopulmonary, fatigue, gastrointestinal, pain) and a general propensity toward being symptomatic. This study aimed to determine what specific physical symptoms, and correlates, that are most strongly associated with this general factor.

Method
A systematic review was based on factor analyses of the Patient Health Questionnaire 15 (PHQ-15) and Somatic Symptom Scale 8 (SSS-8).

Results
There was heterogeneity in the included studies, in terms of the exact specification of the factor structure, and to some extent regarding item inclusion for factor analysis. Among 11 analyses of the PHQ-15, the highest mean and median factor loadings on the general symptom burden factor were seen for fatigue (M = 0.65) followed by dizziness (0.63). Among three analyses of the SSS-8, the mean was highest for chest pain and shortness of breath (0.69), followed by fatigue (0.62). The PHQ-15 general factor exhibited variable, but usually moderate to strong, associations with anxiety and depression symptoms, health anxiety, somatosensory amplification, and functional somatic syndromes.

Conclusions
Cardiopulmonary symptoms and fatigue appear to be especially closely associated with general somatic symptom burden. The close associations between this general factor and indicators of poor mental health and functional somatic syndromes allow for numerous interpretations; both causal and due to overlapping definitions.

Open access

 

[Andy]

Related study, Measurement Properties of the Patient Health Questionnaire–15 and Somatic Symptom Scale–8: A Systematic Review and Meta-Analysis 2024 Axelsson et al

 

[Utsikt]

Conclusions
Cardiopulmonary symptoms and fatigue appear to be especially closely associated with general somatic symptom burden. The close associations between this general factor and indicators of poor mental health and functional somatic syndromes allow for numerous interpretations; both causal and due to overlapping definitions.

Essentially, the categories are so vague that they allow anything to be included, and it can always be interpreted in favour of the author’s hypotheses about causation.

I would have preferred if they said that the forms can’t under any circumstances evaluate or confirm causation.

 

[rvallee]

a general propensity toward being symptomatic

A what in the what now? Good grief. What do they mean by that?

Typically, the general propensity for experiencing physical symptoms regardless of symptom domain also appears to be moderately to strongly associated with symptoms of depression, various forms of symptom preoccupation such as health anxiety, and functional somatic syndromes.

Having symptoms is associated with having symptoms. Genius insight. Novel finding, and so on.

This view, that the propensity for a general somatic symptom burden shares risk and maintaining factors with internalizing psychopathology, is in line with recent work identifying these constructs as part of the same emotional dysfunction superspectrum [36].

Generic constructs built for the purpose of building generic constructs allow for generic interpretations. Usefulness factor? Zero.

The close associations between this general factor and indicators of poor mental health and functional somatic syndromes allow for numerous interpretations; both causal and due to overlapping definitions.

Yeah, no shit. Interpretation-based medicine meets "Imagine a world"-based medicine in an enshittified race to the bottom.