Evidence map›Paper›PMID 39779277›Full record

ArticleBMJ open2025

Five-year trajectories of symptom severity, physical and mental functioning in patients with persistent somatic symptoms: the PROSPECTS cohort study.

Hieke Barends, Henriëtte E van der Horst, Johannes C van der Wouden, Nikki Claassen, Joost Dekker, Trynke Hoekstra

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Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Hieke BarendsDepartment of General Practice, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands h.barends@amsterdamumc.nl.ORCID http://orcid.org/0000-0002-5480-0017
Henriëtte E van der HorstDepartment of General Practice, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0003-4060-4354
Johannes C van der WoudenDepartment of General Practice, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
Nikki ClaassenDepartment of General Practice, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
Joost DekkerAmsterdam Public Health research institute, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0003-2027-0027
Trynke HoekstraAmsterdam Public Health research institute, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-0535-0056

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesKnowledge about the long-term course and prognosis of persistent somatic symptoms (PSS) is important to improve clinical decision-making and guidance for patients with PSS. Therefore, we aimed to: (1) identify distinct 5-year trajectories of symptom severity, physical and mental functioning in adult patients with PSS and (2) explore patient characteristics associated with these trajectories.

designWe used longitudinal data (seven measurements over a 5-year period) of the PROSPECTS study: a prospective cohort of adult patients with PSS. We applied Latent Class Growth Mixture Modelling to identify distinct trajectories for the three outcomes. SETTING AND

participantsPatients were recruited in general practices and specialised treatment facilities for PSS throughout the Netherlands. The study population consisted of participants with three or more measurements available (n=297). PRIMARY OUTCOME MEASURES: Symptom severity (Patient Health Questionnaire 15), physical and mental functioning (RAND-36 Physical Component Summary and Mental Component Summary).

resultsFor symptom severity, we identified two 'stable' trajectories: 'severe symptoms, stable' (15.8%) and 'moderate symptoms, stable' (84.2%). For physical functioning, we identified three trajectories: 'poor physical functioning, marked improvement' (8.5%); 'poor physical functioning, stable' (34.7%) and 'moderate physical functioning, slight improvement' (56.8%). For mental functioning, we identified three trajectories: 'poor mental functioning, marked improvement' (13.9%); 'moderate mental functioning, deterioration' (12.2%) and 'moderate mental functioning, slight improvement' (73.8%). Patients' characteristics such as personal, social and environmental background, illness stressors, comorbid diseases, cognitive, emotional and behavioural responses varied for the distinct trajectories.

conclusionsWe identified distinct 5-year trajectories for the three outcomes. Our findings suggest a high prevalence of persistence of symptoms and limited improvement in physical and mental functioning in the majority of patients with PSS. In a small proportion of patients, we identified trajectories that showed considerable physical or mental improvement or deterioration. Patient characteristics differed for the identified trajectories and may guide early recognition, although predictive studies are warranted.

Indexed as

Medically Unexplained SymptomsSeverity of Illness IndexAdultAgedFemaleHumansLongitudinal StudiesMaleMental HealthMiddle AgedNetherlandsPrognosisProspective StudiesQuality of LifeGENERAL MEDICINE (see Internal Medicine)Patient-Centered CarePatient Reported Outcome MeasuresPrimary CarePrognosis

Identifiers

PMID39779277
PMCPMC11749328

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.