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

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.

Automated summary

This study aimed to investigate the association between functional somatic disorders (FSD) and perceived stress and self-efficacy, respectively, and to examine if FSD differed from severe physical diseases in these aspects. The results showed that FSD were associated with higher perceived stress and lower self-efficacy, especially for certain types of FSD and chronic fatigue. However, controlling for the personality trait neuroticism changed the association with self-efficacy to become insignificant. The analysis did not support an important interaction between perceived stress and self-efficacy in the likelihood of having FSD.