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. 2020 Aug:135:110131.
doi: 10.1016/j.jpsychores.2020.110131. Epub 2020 May 8.

Impact of symptom focusing and somatosensory amplification on persistent physical symptoms: A three-year follow-up study

Hieke Barends  1 , Nikki Claassen-van Dessel  2 , Johannes C van der Wouden  3 , Jos W R Twisk  4 , Berend Terluin  5 , Henriëtte E van der Horst  6 , Joost Dekker  7
Affiliations

Impact of symptom focusing and somatosensory amplification on persistent physical symptoms: A three-year follow-up study

Hieke Barends et al. J Psychosom Res. 2020 Aug.

Abstract

Objective: The somatosensory amplification theory considers symptom focusing and somatosensory amplification as important perpetuating factors of persistent physical symptoms. We investigated whether symptom focusing and somatosensory amplification were associated with symptom severity and mental and physical functioning over a three-year period in patients with persistent physical symptoms (PPS).

Methods: Baseline, 6-, 12-, 24- and 36-months follow-up data from the PROSPECTS study, a prospective cohort consisting of 325 patients with PPS, were used. We applied longitudinal mixed model analyses to investigate if symptom focusing (CBRQ Symptom Focusing Subscale) and somatosensory amplification (Somatosensory Amplification Scale) at baseline were associated with symptom severity (PHQ-15), mental and physical functioning (RAND-36 MCS and PCS) over three years, using all measurements.

Results: Symptom focusing was associated with increased symptom severity and lower mental and physical functioning over time. Somatosensory amplification at baseline was associated with increased symptom severity and lower mental and physical functioning over time. Effect sizes were small. Associations with baseline symptom focusing decreased over time, associations with baseline somatosensory amplification were more stable. There was no interaction effect of both constructs, but they partly overlapped.

Conclusion: This is the first study to show that over an extended period, symptom focusing and somatosensory amplification are associated with symptom severity and lower mental and physical functioning in patients with PPS. These results support the impact of both symptom focusing and somatosensory amplification on the perpetuation of symptoms and lowered mental and physical functioning in individuals with PPS.

Keywords: Medically unexplained symptoms; Perpetuating factors; Persistent physical symptoms; Somatosensory amplification; Symptom focusing.

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Conflict of interest statement

Declaration of Competing Interest All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf and declare that apart from the institutional grants mentioned above, there are no other potential competing interests to report.

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