Persistent SOMAtic symptoms ACROSS diseases — from risk factors to modification: scientific framework and overarching protocol of the interdisciplinary SOMACROSS research unit (RU 5211)
IntroductionPersistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden often correlates poorly with the underlying disease severity, and patients’ needs for effective treatment are far from be...
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| Published in | BMJ open Vol. 12; no. 1; p. e057596 |
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| Main Authors | , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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England
British Medical Journal Publishing Group
21.01.2022
BMJ Publishing Group LTD BMJ Publishing Group |
| Series | Protocol |
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| Abstract | IntroductionPersistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden often correlates poorly with the underlying disease severity, and patients’ needs for effective treatment are far from being met. Initial evidence indicates that, in addition to disease-specific pathophysiological processes, psychological factors such as expectations, somatosensory amplification and prior illness experiences contribute to symptom persistence in functional as well as in somatic diseases. However, prospective studies investigating the transition from acute to chronic somatic symptoms, integrating pathophysiological, psychological and social factors, are scarce. A better understanding of the multifactorial mechanisms of symptom persistence is crucial for developing targeted mechanism-based interventions for effective prevention and treatment of PSS. Thus, the overall aim of the interdisciplinary SOMACROSS research unit is to identify generic and disease-specific risk factors and aetiological mechanisms of symptom persistence across a range of diseases.Methods and analysisSeven projects will investigate risk factors and mechanisms of symptom persistence in a total of 3916 patients across 10 medical conditions. All study designs are prospective and share common assessment points, core instruments and outcome variables to allow comparison and validation of results across projects and conditions. Research will focus on the identification of generic and disease-specific mechanisms associated with unfavourable symptom course. The development of a multivariate prediction model will facilitate the understanding of the course of PSS across diseases.Ethics and disseminationAll individual SOMACROSS studies were approved by the ethics committees of the Medical Chambers Hamburg and Münster, Germany. Findings will be disseminated through peer-reviewed publications, scientific conferences and the involvement of relevant stakeholders, patients and the lay public. This interdisciplinary research unit will fundamentally contribute to earlier recognition of patients at risk, and to the development of prevention and tailored treatment concepts for PSS. |
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| AbstractList | Persistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden often correlates poorly with the underlying disease severity, and patients' needs for effective treatment are far from being met. Initial evidence indicates that, in addition to disease-specific pathophysiological processes, psychological factors such as expectations, somatosensory amplification and prior illness experiences contribute to symptom persistence in functional as well as in somatic diseases. However, prospective studies investigating the transition from acute to chronic somatic symptoms, integrating pathophysiological, psychological and social factors, are scarce. A better understanding of the multifactorial mechanisms of symptom persistence is crucial for developing targeted mechanism-based interventions for effective prevention and treatment of PSS. Thus, the overall aim of the interdisciplinary SOMACROSS research unit is to identify generic and disease-specific risk factors and aetiological mechanisms of symptom persistence across a range of diseases.INTRODUCTIONPersistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden often correlates poorly with the underlying disease severity, and patients' needs for effective treatment are far from being met. Initial evidence indicates that, in addition to disease-specific pathophysiological processes, psychological factors such as expectations, somatosensory amplification and prior illness experiences contribute to symptom persistence in functional as well as in somatic diseases. However, prospective studies investigating the transition from acute to chronic somatic symptoms, integrating pathophysiological, psychological and social factors, are scarce. A better understanding of the multifactorial mechanisms of symptom persistence is crucial for developing targeted mechanism-based interventions for effective prevention and treatment of PSS. Thus, the overall aim of the interdisciplinary SOMACROSS research unit is to identify generic and disease-specific risk factors and aetiological mechanisms of symptom persistence across a range of diseases.Seven projects will investigate risk factors and mechanisms of symptom persistence in a total of 3916 patients across 10 medical conditions. All study designs are prospective and share common assessment points, core instruments and outcome variables to allow comparison and validation of results across projects and conditions. Research will focus on the identification of generic and disease-specific mechanisms associated with unfavourable symptom course. The development of a multivariate prediction model will facilitate the understanding of the course of PSS across diseases.METHODS AND ANALYSISSeven projects will investigate risk factors and mechanisms of symptom persistence in a total of 3916 patients across 10 medical conditions. All study designs are prospective and share common assessment points, core instruments and outcome variables to allow comparison and validation of results across projects and conditions. Research will focus on the identification of generic and disease-specific mechanisms associated with unfavourable symptom course. The development of a multivariate prediction model will facilitate the understanding of the course of PSS across diseases.All individual SOMACROSS studies were approved by the ethics committees of the Medical Chambers Hamburg and Münster, Germany. Findings will be disseminated through peer-reviewed publications, scientific conferences and the involvement of relevant stakeholders, patients and the lay public. This interdisciplinary research unit will fundamentally contribute to earlier recognition of patients at risk, and to the development of prevention and tailored treatment concepts for PSS.ETHICS AND DISSEMINATIONAll individual SOMACROSS studies were approved by the ethics committees of the Medical Chambers Hamburg and Münster, Germany. Findings will be disseminated through peer-reviewed publications, scientific conferences and the involvement of relevant stakeholders, patients and the lay public. This interdisciplinary research unit will fundamentally contribute to earlier recognition of patients at risk, and to the development of prevention and tailored treatment concepts for PSS. Persistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden often correlates poorly with the underlying disease severity, and patients' needs for effective treatment are far from being met. Initial evidence indicates that, in addition to disease-specific pathophysiological processes, psychological factors such as expectations, somatosensory amplification and prior illness experiences contribute to symptom persistence in functional as well as in somatic diseases. However, prospective studies investigating the transition from acute to chronic somatic symptoms, integrating pathophysiological, psychological and social factors, are scarce. A better understanding of the multifactorial mechanisms of symptom persistence is crucial for developing targeted mechanism-based interventions for effective prevention and treatment of PSS. Thus, the overall aim of the interdisciplinary SOMACROSS research unit is to identify generic and disease-specific risk factors and aetiological mechanisms of symptom persistence across a range of diseases. Seven projects will investigate risk factors and mechanisms of symptom persistence in a total of 3916 patients across 10 medical conditions. All study designs are prospective and share common assessment points, core instruments and outcome variables to allow comparison and validation of results across projects and conditions. Research will focus on the identification of generic and disease-specific mechanisms associated with unfavourable symptom course. The development of a multivariate prediction model will facilitate the understanding of the course of PSS across diseases. All individual SOMACROSS studies were approved by the ethics committees of the Medical Chambers Hamburg and Münster, Germany. Findings will be disseminated through peer-reviewed publications, scientific conferences and the involvement of relevant stakeholders, patients and the lay public. This interdisciplinary research unit will fundamentally contribute to earlier recognition of patients at risk, and to the development of prevention and tailored treatment concepts for PSS. IntroductionPersistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden often correlates poorly with the underlying disease severity, and patients’ needs for effective treatment are far from being met. Initial evidence indicates that, in addition to disease-specific pathophysiological processes, psychological factors such as expectations, somatosensory amplification and prior illness experiences contribute to symptom persistence in functional as well as in somatic diseases. However, prospective studies investigating the transition from acute to chronic somatic symptoms, integrating pathophysiological, psychological and social factors, are scarce. A better understanding of the multifactorial mechanisms of symptom persistence is crucial for developing targeted mechanism-based interventions for effective prevention and treatment of PSS. Thus, the overall aim of the interdisciplinary SOMACROSS research unit is to identify generic and disease-specific risk factors and aetiological mechanisms of symptom persistence across a range of diseases.Methods and analysisSeven projects will investigate risk factors and mechanisms of symptom persistence in a total of 3916 patients across 10 medical conditions. All study designs are prospective and share common assessment points, core instruments and outcome variables to allow comparison and validation of results across projects and conditions. Research will focus on the identification of generic and disease-specific mechanisms associated with unfavourable symptom course. The development of a multivariate prediction model will facilitate the understanding of the course of PSS across diseases.Ethics and disseminationAll individual SOMACROSS studies were approved by the ethics committees of the Medical Chambers Hamburg and Münster, Germany. Findings will be disseminated through peer-reviewed publications, scientific conferences and the involvement of relevant stakeholders, patients and the lay public. This interdisciplinary research unit will fundamentally contribute to earlier recognition of patients at risk, and to the development of prevention and tailored treatment concepts for PSS. |
| Author | Van den Bergh, Omer Ständer, Sonja Löwe, Bernd Schneider, Gudrun Toussaint, Anne von dem Knesebeck, Olaf Schramm, Christoph Vettorazzi, Eik Andresen, Viola Nestoriuc, Yvonne Huber, Tobias B Schneider, Stefan W Shedden-Mora, Meike Zapf, Antonia Lohse, Ansgar W |
| AuthorAffiliation | 9 Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Münster , Münster , Germany 4 III. Department of Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany 8 Institute of Systems Neuroscience , University Medical Center Hamburg-Eppendorf , Hamburg , Germany 13 Institute of Medical Biometry and Epidemiology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany 2 Department of Gastroenterology , Israelitic Hospital , Hamburg , Germany 11 Martin Zeitz Center for Rare Diseases , University Medical Center Hamburg-Eppendorf , Hamburg , Germany 5 Medical Sociology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany 3 Research Group on Health Psychology , University of Leuven , Leuven , Belgium 6 I. Department of Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany 14 Department of Psychology , Medical School Hamburg , Hamburg , Germany 7 Department of Psychology , Helmut-Schmidt-University/University of |
| AuthorAffiliation_xml | – name: 3 Research Group on Health Psychology , University of Leuven , Leuven , Belgium – name: 7 Department of Psychology , Helmut-Schmidt-University/University of the Armed Forces Hamburg , Hamburg , Germany – name: 14 Department of Psychology , Medical School Hamburg , Hamburg , Germany – name: 4 III. Department of Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 11 Martin Zeitz Center for Rare Diseases , University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 5 Medical Sociology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 9 Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Münster , Münster , Germany – name: 13 Institute of Medical Biometry and Epidemiology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 8 Institute of Systems Neuroscience , University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 1 Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 2 Department of Gastroenterology , Israelitic Hospital , Hamburg , Germany – name: 10 Department of Dermatology and Venerology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 12 Department of Dermatology , Medical University Center Münster , Münster , Germany – name: 6 I. Department of Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany |
| Author_xml | – sequence: 1 givenname: Bernd orcidid: 0000-0003-4220-3378 surname: Löwe fullname: Löwe, Bernd email: b.loewe@uke.de organization: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 2 givenname: Viola surname: Andresen fullname: Andresen, Viola organization: Department of Gastroenterology, Israelitic Hospital, Hamburg, Germany – sequence: 3 givenname: Omer surname: Van den Bergh fullname: Van den Bergh, Omer organization: Research Group on Health Psychology, University of Leuven, Leuven, Belgium – sequence: 4 givenname: Tobias B surname: Huber fullname: Huber, Tobias B organization: III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 5 givenname: Olaf surname: von dem Knesebeck fullname: von dem Knesebeck, Olaf organization: Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 6 givenname: Ansgar W surname: Lohse fullname: Lohse, Ansgar W organization: I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 7 givenname: Yvonne surname: Nestoriuc fullname: Nestoriuc, Yvonne organization: Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 8 givenname: Gudrun surname: Schneider fullname: Schneider, Gudrun organization: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Münster, Münster, Germany – sequence: 9 givenname: Stefan W surname: Schneider fullname: Schneider, Stefan W organization: Department of Dermatology and Venerology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 10 givenname: Christoph surname: Schramm fullname: Schramm, Christoph organization: Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 11 givenname: Sonja surname: Ständer fullname: Ständer, Sonja organization: Department of Dermatology, Medical University Center Münster, Münster, Germany – sequence: 12 givenname: Eik surname: Vettorazzi fullname: Vettorazzi, Eik organization: Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 13 givenname: Antonia surname: Zapf fullname: Zapf, Antonia organization: Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany – sequence: 14 givenname: Meike surname: Shedden-Mora fullname: Shedden-Mora, Meike organization: Department of Psychology, Medical School Hamburg, Hamburg, Germany – sequence: 15 givenname: Anne surname: Toussaint fullname: Toussaint, Anne organization: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35063961$$D View this record in MEDLINE/PubMed |
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| Keywords | hepatology adult psychiatry gastroenterology adult dermatology chronic renal failure functional bowel disorders |
| Language | English |
| License | This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
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| Snippet | IntroductionPersistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The... Persistent somatic symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom... |
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| SubjectTerms | adult dermatology adult psychiatry chronic renal failure Coronary vessels Disease Etiology functional bowel disorders gastroenterology Germany hepatology Humans Interdisciplinary Research Medically Unexplained Symptoms Mental disorders Mental Health Pathophysiology Patients Prospective Studies Psychological aspects Quality of life Risk Factors Surgery |
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| Title | Persistent SOMAtic symptoms ACROSS diseases — from risk factors to modification: scientific framework and overarching protocol of the interdisciplinary SOMACROSS research unit (RU 5211) |
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