Functional somatic disorder (FSD) is a unifying diagnosis that includes functional somatic syndromes such as irritable bowel, chronic widespread pain (CWP) and chronic fatigue. Several psychological factors are associated with FSD. However, longitudinal population-based studies elucidating the causal relationship are scarce.

To explore if neuroticism, perceived stress, adverse life events (ALEs) and self-efficacy can predict the development of FSD over a 5-year period.

A total of 4288 individuals who participated in the DanFunD baseline and 5-year follow-up investigations were included. FSD was established at both baseline and follow-up, with symptom questionnaires and diagnostic interviews. Neuroticism was measured with the short-form NEO Personality Inventory, perceived stress with the Cohen's Perceived Stress Scale, ALEs with the Danish version of the Cumulative Lifetime Adversity Measure and self-efficacy with the General Self-Efficacy Scale. Associations were investigated with multiple logistic regression models.

Perceived stress predicted incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.04–1.17). Neuroticism predicted incident FSD and chronic fatigue (odds ratios: 1.03–1.16). ALEs predicted incident FSD, CWP and chronic fatigue (odds ratios: 1.06–1.18). An increase in perceived stress from baseline to follow-up was associated with incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.05–1.22). Contrary, an increase in self-efficacy seemed to be a protective factor (odds ratios: 0.89–0.99).

High neuroticism, high perceived stress and a high number of ALEs are risk factors for the development of FSD. Particularly perceived stress seems to be an important contributor to the onset of FSD.

Functional somatic disorders (FSDs) are characterized by persistent and disabling physical symptoms that cannot be attributed to well-defined somatic disorders. In adolescents, the prevalence is around 4-10%. Evidence from adult populations suggests that cortisol plays a role in the development and perpetuation of FSDs, but little is known regarding adolescents. As cortisol accumulates in hair over time, hair cortisol concentration (HCC) is a promising new biomarker for long-term physiological stress. Moreover, adult studies have found associations between HCC levels and self-perceived stress.

To compare HCC levels between adolescents with severe FSDs and adolescents from the general population. Furthermore, to investigate the association between HCC and self-perceived stress.

The data are retrieved from two projects: the AHEAD trial, including 91 15-19-year-old adolescents diagnosed with a severe FSD, and the Copenhagen Child Cohort 2000 (CCC2000), including data on 1455 16-17-year-old adolescents. Hair samples were collected for HCC analysis, and web-based questionnaires were used to asses self-perceived stress. Functional somatic symptoms were assessed with the Bodily Distress Syndrome (BDS) checklist.

The data have been collected and will be analysed and presented at the congress.

This study can contribute with knowledge about the potential role of cortisol in FSDs in adolescents, and whether self-perceived stress can be used as a marker for physiological stress measured by HCC. Treatments for adolescents with FSDs still need to be improved. The current study may help to understand whether future treatment strategies should include a greater focus on stress management.

No significant relationships.