The relationship between psychological distress and somatic symptoms in organic neurological disorders

Abstract

Background: The prevalence of psychological distress in patients with organic neurological disorders (ONDs) is high. The detection and treatment of anxiety and depression in the population however, remains low. Mental health difficulties may exacerbate physical ailments. No published study has examined the relationship between psychological and somatic symptoms in this group. Methods: The study used a cross-sectional design with standardised self-report measures. Participants were recruited from a large, urban neurology department. Psychological distress was measured using the Hospital Anxiety and Depression Scale. Somatic symptoms were measured using the Patient Health Questionnaire-15. Results: N=103 patients with ONDs took part. The most common diagnoses were Multiple Sclerosis (39.9%), neuropathy (10.6%) and epilepsy (5.9%). The most prevalent somatic symptoms were fatigue, pain in limbs/joints/back and sleep disturbance, with over 69% of participants experiencing any one of these symptoms. The majority of participants reported that these symptoms ‘bothered them a lot’. Multiple regression showed that psychological distress accounted for 35% of the overall variance in somatic symptoms. Anxiety (β = .40, t = 4.34, p < .001) was shown to have a stronger effect when compared to depression (β = .25, t = 2.35, p = .021). Conclusions: Two out of four of the most prevalent somatic symptoms, fatigue and trouble sleeping, overlap with signs of clinical depression. This study has uniquely captured the significant role of anxiety in the physical health of neurology patients. Findings demonstrate the need for increased liaison between Psychology and Neurology to screen and support patients with ONDs.