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A population-based twin study of functional somatic syndromes
Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm. (School of Nursing and Rehabilitation, International University of Health and Welfare at Odawara, Kanagawa, Japan)
Dept Genetics, Univ of North Carolina, Dept Medical Epid and Biostat, Karol Institutet. (Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden)
Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases. (Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden)
Dept Medical Epidemiology and Biostatistis, Karolinska Institutet. (Department of Psychology, University of Southern California, Los Angeles, CA, USA)
2009 (English)In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 39, no 3, 497-505 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The mechanisms underlying the co-occurrence of the functional somatic syndromes are largely unknown. No empirical study has explicitly examined how genetic and environmental factors influence the co-morbidity of these syndromes. We aimed to examine how the co-morbidity of functional somatic syndromes is influenced by genetic and environmental factors that are in common to the syndromes. METHOD: A total of 31318 twins in the Swedish Twin Registry aged 41-64 years underwent screening interviews via a computer-assisted telephone system from 1998 to 2002. Four functional somatic syndromes (chronic widespread pain, chronic fatigue, irritable bowel syndrome, and recurrent headache) and two psychiatric disorders (major depression and generalized anxiety disorder) were assessed using structured questions based on standard criteria for each illness in a blinded manner. RESULTS: Multivariate twin analyses revealed that a common pathway model with two latent traits that were shared by the six illnesses fit best to the women's data. One of the two latent traits loaded heavily on the psychiatric disorders, whereas the other trait loaded on all four of the functional somatic syndromes, particularly chronic widespread pain, but not on the psychiatric disorders. All illnesses except the psychiatric disorders were also affected by genetic influences that were specific to each. CONCLUSIONS: The co-occurrence of functional somatic syndromes in women can be best explained by affective and sensory components in common to all these syndromes, as well as by unique influences specific to each of them. The findings clearly suggest a complex view of the multifactorial pathogenesis of these illnesses.

Place, publisher, year, edition, pages
Cambridge University Press, 2009. Vol. 39, no 3, 497-505 p.
Keyword [en]
Chronic fatigue, co-morbidity, functional somatic syndromes, pain, twins
National Category
Medical and Health Sciences Infectious Medicine Psychology Nursing Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-27077DOI: 10.1017/S0033291708003784PubMedID: 18578896OAI: diva2:276080
Published online: 26 June 2008Available from: 2009-11-10 Created: 2009-11-10 Last updated: 2012-02-14Bibliographically approved

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