Clinical outcomes, medical costs, and medication usage patterns of different somatic symptom disorders and functional somatic syndromes: a population-based study in Taiwan

• Published in: Psychological medicine Vol. 54; no. 7; pp. 1452 - 1460
• Main Authors: Wu, Chi-Shin, Chen, Tzu-Ting, Liao, Shih-Cheng, Huang, Wei-Chia, Huang, Wei-Lieh
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01.05.2024
• Subjects: American dollar; Analgesics; Chronic fatigue syndrome; Clinical outcomes; Codes; Cohort analysis; Cohort Studies; Comorbidity; Demographics; Drugs; Dyspepsia; Fibromyalgia; Functional dyspepsia; Health care expenditures; Health services utilization; Hospitalization; Humans; Irritable bowel syndrome; Linear analysis; Medically Unexplained Symptoms; Mortality; National health insurance; Newly diagnosed; Population; Population studies; Psychiatric hospitals; Psychotropic drugs; Regression analysis; Research Design; Somatoform disorders; Somatoform Disorders - drug therapy; Somatoform Disorders - epidemiology; Somatoform Disorders - psychology; Statistical analysis; Statistical models; Suicide; Taiwan - epidemiology; Use statistics; Taiwan; United States > US; clinical outcomes; functional somatic syndromes; medical costs; medication usage patterns; somatic symptom disorders
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291723003355

Somatic symptom disorders (SSD) and functional somatic syndromes (FSS) are often regarded as similar diagnostic constructs; however, whether they exhibit similar clinical outcomes, medical costs, and medication usage patterns has not been examined in nationwide data. Therefore, this study focused on analyzing SSD and four types of FSS (fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, functional dyspepsia). This population-based matched cohort study utilized Taiwan's National Health Insurance (NHI) claims database to investigate the impact of SSD/FSS. The study included 2 615 477 newly diagnosed patients with SSD/FSS and matched comparisons from the NHI beneficiary registry. Healthcare utilization, mortality, medical expenditure, and medication usage were assessed as outcome measures. Statistical analysis involved Cox regression models for hazard ratios, generalized linear models for comparing differences, and adjustment for covariates. All SSD/FSS showed significantly higher adjusted hazard ratios for psychiatric hospitalization and all-cause hospitalization compared to the control group. All SSD/FSS exhibited significantly higher adjusted hazard ratios for suicide, and SSD was particularly high. All-cause mortality was significantly higher in all SSD/FSS. Medical costs were significantly higher for all SSD/FSS compared to controls. The usage duration of all psychiatric medications and analgesics was significantly higher in SSD/FSS compared to the control group. All SSD/FSS shared similar clinical outcomes and medical costs. The high hazard ratio for suicide in SSD deserves clinical attention.