功能性躯体疾病的自主神经觉醒和心率变异性——一项基于横断面人群的研究

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-07-06 DOI:10.1016/j.jpsychores.2025.112193

Lise Gormsen , Henning Mølgaard , Thomas Meinertz Dantoft , Anne Arendt Bjerregaard , Per Fink , Marie Weinreich Petersen

{"title":"功能性躯体疾病的自主神经觉醒和心率变异性——一项基于横断面人群的研究","authors":"Lise Gormsen , Henning Mølgaard , Thomas Meinertz Dantoft , Anne Arendt Bjerregaard , Per Fink , Marie Weinreich Petersen","doi":"10.1016/j.jpsychores.2025.112193","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>The bodily distress syndrome (BDS) checklist has proven to be useful diagnostic aid and as screening tool for functional somatic disorder (FSD). It has been hypotheses that the symptoms clusters of the checklist represent autonomic activity. This study aims to investigate associations between autonomic activity (Heart rate variability, HRV) and somatic symptoms profiles measured by the BDS checklist and diagnoses of FSD based on interviews.</div></div><div><h3>Methods</h3><div>This cross-sectional population-based study included 6891 men and women aged 18–72 years. Somatic symptom profiles were measured by the 25-item BDS checklist, and five short-term HRV measures (MeanRR, RMSSD, LF, HF, and LF/HF) were obtained. In a stratified subsample (<em>n</em> = 1590), diagnoses of FSD was established by diagnostic interviews, performed by trained family physicians. Associations were tested with regression models. Measures of associations were mean difference with 95 % confidence intervals (CIs) for Mean RR and median ratio and 95 % CI for RMSS, LF, HF, and LF/HF.</div></div><div><h3>Results</h3><div>Overall, higher BDS checklist scores were associated with lower HRV, particularly reduced mean RR intervals (−0.86, 95 % CI: −0,24;-0,49 for the total sum score). The strongest associations were seen for the cardiopulmonary symptom cluster (−3.58, 95 % CI: −0,05;-2.10). Clinically diagnosed FSD cases also showed lower mean RR compared to non-cases (−23.12, 95 % CI: −41.17;-5.07), especially the multi-organ type (−39.44, 95 % CI: −75.49;-3.39).</div></div><div><h3>Conclusions</h3><div>The study indicate that the symptom clusters of the BDS checklist are associated with autonomic arousal as measured by HRV. Further that individuals with FSD, especially the multi-organ type, had an increased sympathetic neural and neurohormonal activity, suggesting this may be an important physiological mechanism in FSD.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"196 ","pages":"Article 112193"},"PeriodicalIF":3.3000,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Autonomic arousal and heart rate variability in functional somatic disorder - a cross-sectional population-based study\",\"authors\":\"Lise Gormsen , Henning Mølgaard , Thomas Meinertz Dantoft , Anne Arendt Bjerregaard , Per Fink , Marie Weinreich Petersen\",\"doi\":\"10.1016/j.jpsychores.2025.112193\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>The bodily distress syndrome (BDS) checklist has proven to be useful diagnostic aid and as screening tool for functional somatic disorder (FSD). It has been hypotheses that the symptoms clusters of the checklist represent autonomic activity. This study aims to investigate associations between autonomic activity (Heart rate variability, HRV) and somatic symptoms profiles measured by the BDS checklist and diagnoses of FSD based on interviews.</div></div><div><h3>Methods</h3><div>This cross-sectional population-based study included 6891 men and women aged 18–72 years. Somatic symptom profiles were measured by the 25-item BDS checklist, and five short-term HRV measures (MeanRR, RMSSD, LF, HF, and LF/HF) were obtained. In a stratified subsample (<em>n</em> = 1590), diagnoses of FSD was established by diagnostic interviews, performed by trained family physicians. Associations were tested with regression models. Measures of associations were mean difference with 95 % confidence intervals (CIs) for Mean RR and median ratio and 95 % CI for RMSS, LF, HF, and LF/HF.</div></div><div><h3>Results</h3><div>Overall, higher BDS checklist scores were associated with lower HRV, particularly reduced mean RR intervals (−0.86, 95 % CI: −0,24;-0,49 for the total sum score). The strongest associations were seen for the cardiopulmonary symptom cluster (−3.58, 95 % CI: −0,05;-2.10). Clinically diagnosed FSD cases also showed lower mean RR compared to non-cases (−23.12, 95 % CI: −41.17;-5.07), especially the multi-organ type (−39.44, 95 % CI: −75.49;-3.39).</div></div><div><h3>Conclusions</h3><div>The study indicate that the symptom clusters of the BDS checklist are associated with autonomic arousal as measured by HRV. Further that individuals with FSD, especially the multi-organ type, had an increased sympathetic neural and neurohormonal activity, suggesting this may be an important physiological mechanism in FSD.</div></div>\",\"PeriodicalId\":50074,\"journal\":{\"name\":\"Journal of Psychosomatic Research\",\"volume\":\"196 \",\"pages\":\"Article 112193\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-07-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Psychosomatic Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0022399925001576\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Psychosomatic Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022399925001576","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

摘要

目的躯体窘迫综合征（BDS）检查表是功能性躯体障碍（FSD）的诊断辅助和筛查工具。有假设认为，检查表的症状群代表自主神经活动。本研究旨在探讨自主神经活动（心率变异性，HRV）与BDS检查表测量的躯体症状之间的关系，以及基于访谈的FSD诊断。方法本研究纳入6891名年龄在18-72岁的男性和女性。采用25项BDS检查表测量躯体症状，并获得5项短期HRV测量（MeanRR、RMSSD、LF、HF和LF/HF）。在分层子样本（n = 1590）中，FSD的诊断是由训练有素的家庭医生进行的诊断性访谈确定的。用回归模型检验相关性。测量相关性的方法是平均RR和中位比的95%置信区间（CI）和RMSS、LF、HF和LF/HF的95% CI的平均差异。结果总体而言，较高的BDS检查表得分与较低的HRV相关，特别是平均RR区间缩短（- 0.86,95% CI: - 0,24;-0,49为总得分）。心肺症状组的相关性最强（- 3.58,95% CI: - 0.05;-2.10）。临床诊断的FSD病例的平均RR也低于非病例（- 23.12,95% CI: - 41.17;-5.07），尤其是多器官型（- 39.44,95% CI: - 75.49;-3.39）。结论本研究表明，BDS检查表的症状群与HRV测量的自主神经觉醒有关。此外，FSD患者，尤其是多器官型FSD患者，交感神经和神经激素活动增加，表明这可能是FSD的重要生理机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Autonomic arousal and heart rate variability in functional somatic disorder - a cross-sectional population-based study

Objective

The bodily distress syndrome (BDS) checklist has proven to be useful diagnostic aid and as screening tool for functional somatic disorder (FSD). It has been hypotheses that the symptoms clusters of the checklist represent autonomic activity. This study aims to investigate associations between autonomic activity (Heart rate variability, HRV) and somatic symptoms profiles measured by the BDS checklist and diagnoses of FSD based on interviews.

Methods

This cross-sectional population-based study included 6891 men and women aged 18–72 years. Somatic symptom profiles were measured by the 25-item BDS checklist, and five short-term HRV measures (MeanRR, RMSSD, LF, HF, and LF/HF) were obtained. In a stratified subsample (n = 1590), diagnoses of FSD was established by diagnostic interviews, performed by trained family physicians. Associations were tested with regression models. Measures of associations were mean difference with 95 % confidence intervals (CIs) for Mean RR and median ratio and 95 % CI for RMSS, LF, HF, and LF/HF.

Results

Overall, higher BDS checklist scores were associated with lower HRV, particularly reduced mean RR intervals (−0.86, 95 % CI: −0,24;-0,49 for the total sum score). The strongest associations were seen for the cardiopulmonary symptom cluster (−3.58, 95 % CI: −0,05;-2.10). Clinically diagnosed FSD cases also showed lower mean RR compared to non-cases (−23.12, 95 % CI: −41.17;-5.07), especially the multi-organ type (−39.44, 95 % CI: −75.49;-3.39).

Conclusions

The study indicate that the symptom clusters of the BDS checklist are associated with autonomic arousal as measured by HRV. Further that individuals with FSD, especially the multi-organ type, had an increased sympathetic neural and neurohormonal activity, suggesting this may be an important physiological mechanism in FSD.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.