High Perceived Stress and Low Self-Efficacy are Associated with Functional Somatic Disorders: The DanFunD Study

Abstract

Objective

Several psychological factors have been proposed to be associated with functional somatic disorders (FSD) including functional somatic syndromes, such as irritable bowel, chronic widespread pain, and chronic fatigue. However, large randomly selected population-based studies of this association are sparse. This study aimed to investigate the association between FSD and perceived stress and self-efficacy, respectively, and to investigate if FSD differed from severe physical diseases on these aspects.

Methods

This cross-sectional study included a random sample of the adult Danish population (n = 9656). FSD were established using self-reported questionnaires and diagnostic interviews. Perceived stress was measured with Cohen’s Perceived Stress Scale and self-efficacy with the General Self-Efficacy Scale. Data were analysed with generalized linear models and linear regression models.

Results

FSD were associated with higher perceived stress and lower self-efficacy, especially for the multi-organ and the general symptoms/fatigue FSD types and for chronic fatigue. However, controlling for the personality trait neuroticism altered the associations with self-efficacy so it became insignificant. The analysis did not support an important interaction between perceived stress and self-efficacy on the likelihood of having FSD. Individuals with FSD presented levels of perceived stress that were not equal, ie higher, to those in individuals with severe physical diseases.

Conclusion

FSD were positively associated with perceived stress and negatively associated with self-efficacy. Our study may point to stress being part of the symptomatology of FSD. This underlines the severity of having FSD and stresses the relevance of the resilience theory in the understanding of the condition.

Keywords:

• functional somatic disorders
• functional somatic syndromes
• perceived stress
• self-efficacy
• irritable bowel syndrome
• fibromyalgia
• chronic fatigue syndrome
• population-based

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author, MWP, upon reasonable request.

Ethics Statement

The study complies with the Declaration of Helsinki. It was approved by the Ethical Committee of the Capital Region (H-3-2011-081, H-3-2012-015), and all participants gave written informed consent prior to study commencement.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by grants from the Lundbeck Foundation [grant number R155-2013-14070] and TrygFonden [grant number 7-11-0213 and grant number 153171].