Association between infections and functional somatic disorders: a cross-sectional population-based cohort study

ObjectivesIt has been suggested that infections can trigger functional somatic disorders (FSD). However, current evidence is limited by inconsistent findings in smaller studies conducted in clinical settings within selected populations and short follow-up times. We aimed to test the hypothesis that...

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Published in:	BMJ open Vol. 12; no. 11; p. e066037
Main Authors:	Schovsbo, Signe Ulfbeck, Møllehave, Line Tang, Petersen, Marie Weinreich, Ahrendt Bjerregaard, Anne, Eliasen, Marie, Pedersen, Susanne Brix, Eplov, Lene Falgaard, Kårhus, Line Lund, Fink, Per, Linneberg, Allan, Dantoft, Thomas Meinertz, Jørgensen, Torben, Benros, Michael Eriksen
Format:	Journal Article
Language:	English
Published:	London British Medical Journal Publishing Group 02-11-2022 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Original research
Subjects:	Bacterial infections Chronic fatigue syndrome Cohort analysis Epidemiology Gastroenteritis Hepatitis IMMUNOLOGY Infections INFECTIOUS DISEASES Irritable bowel syndrome Nervous system Pathogens Population Population-based studies PSYCHIATRY PUBLIC HEALTH Questionnaires Sepsis Viral infections
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Summary:	ObjectivesIt has been suggested that infections can trigger functional somatic disorders (FSD). However, current evidence is limited by inconsistent findings in smaller studies conducted in clinical settings within selected populations and short follow-up times. We aimed to test the hypothesis that former infections are associated with FSD using data from nationwide registries and a large population-based cohort study, the Danish Study of Functional Disorders study.DesignFSD cases were identified in a cross-sectional population-based cohort and linked retrospectively to former hospital contacts with infections identified in the Danish National Patient Registry. The associations between FSD and former infections within 17 years were analysed using logistic regressions to calculate ORs and 95% CIs adjusted for age, sex and subjective social status.SettingA population-based cohort in Denmark examined between 2011 and 2015.ParticipantsA total of 9656 men and women aged 18–76 years.Main outcome measuresFSD measured by various delimitations, including bodily distress syndrome (BDS), irritable bowel (IB), chronic fatigue (CF), chronic widespread pain (CWP), and multiple chemical sensitivity (MCS).ResultsOverall, infections were associated with increased risk of all delimitations of FSD. The associations were more pronounced for multisystemic FSD. The number of prior infections increased the risk in a dose-response manner (p<0.0001). Bacterial but not viral infections were significantly associated with BDS (OR 1.69 (95% CI 1.46 to 1.96)), IB (OR 1.41 (95% CI 1.06 to 1.88)), CWP (OR 1.47 (95% CI 1.13 to 1.90)) and CF (OR 1.62 (95% CI 1.34 to 1.96)), but not MCS.ConclusionFormer infections leading to hospital contacts were associated with a higher risk of having FSD. These associations were more pronounced for bacterial than viral infections, and more infections increased the risk in a dose-response manner. These results tend to support the idea that severe infections could play a role in FSD.
Bibliography:	Original research
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2022-066037