FOR 5211:  Persistent Somatic Symptoms Across Diseases: From Risk Factors to Modification

• Subject Area: Medicine ; Social and Behavioural Sciences
• Term: since 2021
• Website: Homepage
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 445297796

Background: Persistent Somatic Symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden correlates poorly with the severity of the underlying disease, and patients’ needs for effective and tailored treatment are far from being met. There is initial evidence indicating that, in addition to disease-specific pathophysiological processes, psychological factors such as expectations of symptom severity, somatosensory amplification, and prior illness experiences contribute to symptom persistence in functional as well as in somatic diseases. However, especially for somatic diseases, there is a lack of prospective studies investigating the transition from acute to chronic somatic symptoms, integrating pathophysiological, psychological, and social factors. A better understanding of the multifactorial mechanisms of symptom persistence is crucial in order to develop targeted interventions for effective prevention and treatment of PSS.Objectives: The overall aim of this interdisciplinary Research Unit is to identify generic and disease-specific risk factors and aetiological mechanisms of symptom persistence across a range of medical diseases, and thereby create a foundation for evidence-based interventions for PSS. Additional aims include the development of multivariate prediction models for PSS, the comparison of mechanisms for a chronic trajectory across diseases, the derivation of generic and disease-specific risk scores, and the modification of risk factors.Work programme: Eight projects will investigate specific risk factors and mechanisms of symptom persistence in a total of 4044 patients with ten different medical conditions. All study designs are prospective and share common assessment points, core instruments, and outcome variables in order to allow comparison and validation of results across projects and diseases. Research in the first four-year funding phase will focus on the identification of generic and disease-specific mechanisms associated with unfavourable symptom course. The development of a prospective multivariate prediction model will facilitate the understanding of the course of PSS across diseases. In the second four-year funding phase, we will, apart from replicating and validating of the findings from the first funding phase, experimentally modify the most promising identified risk factors in order to improve clinical outcomes.Expected impact: This interdisciplinary Research Unit will fundamentally broaden our understanding of the development and persistence of somatic symptoms across various diseases. Comprehensive knowledge of these mechanisms will contribute to earlier recognition of patients at risk, and to the development of prevention and tailored treatment concepts for PSS across diseases. It will thereby create a foundation for improving medical care and quality of life of those affected by PSS.

• DFG Programme: Research Units
• International Connection: Belgium, Israel, Netherlands

Projects

• Biological and Psychosocial Factors Affecting the Persistence of Pruritus Symptoms (RU SOMACROSS Project 4) (Applicants Schneider, Stefan Werner ;  Schneider, Gudrun ;  Ständer, Sonja )
• Coordination Funds (Applicant Löwe, Bernd )
• Fatigue in Primary Biliary Cholangitis: Factors Associated With Severity and Persistence as Future Therapeutic Targets (RU SOMACROSS) (Applicants Schramm, Christoph ;  Toussaint, Ph.D., Anne )
• Generic and Disease-Specific Mechanisms of Somatic Symptom Persistence Across Diseases (RU SOMACROSS) (Applicant Zapf, Antonia )
• Modifiable Factors for Somatic Symptom Persistence in Patients with Somatic Symptom Disorder (RU SOMACROSS) (Applicants Nestoriuc, Yvonne ;  Toussaint, Ph.D., Anne )
• Persistence of Gastrointestinal Symptoms in Irritable Bowel Syndrome and Ulcerative Colitis: From Risk Factors to Modification (RU SOMACROSS) (Applicants Lohse, Ansgar W. ;  Löwe, Bernd )
• Predictors of Somatic Symptom Persistence in Patients With Chronic Kidney Disease (RU SOMACROSS) (Applicants Huber, Tobias B. ;  Shedden Mora, Ph.D., Meike )
• Social Inequalities in Aggravating Factors of Somatic Symptom Persistence (RU SOMACROSS) (Applicant von dem Knesebeck, Olaf )

• Spokesperson: Professor Dr. Bernd Löwe