TY - JOUR
T1 - "Functional somatic syndromes, one or many?"
T2 - An answer by cluster analysis
AU - Lacourt, Tamara
AU - Houtveen, Jan
AU - van Doornen, Lorenz
N1 - Funding Information:
The study was funded by the Linschoten Institute, Utrecht University. Only the authors had a role in the study design, the collection, analysis, and interpretation of the data, the writing of the report and the decision to submit the article for publication.
PY - 2013/1
Y1 - 2013/1
N2 - Objective: The aim of the present study was to address the lumper-splitter discussion on functional somatic syndromes by applying k-means cluster analyses on a heterogeneous sample of persons with unexplained somatic complaints. In favor of the lumper-side of the debate, clusters should differ only on the overall severity of the somatic complaints that were assessed. According to the splitters view, clusters should differ in symptom-specific patterns. Methods: Three-hundred ninety four subjects with functional somatic symptoms were clustered based on their scores on 47 somatic symptoms. Three cluster solutions (k=2,3, and 4 clusters) were compared on overall symptom severity, symptom patterns, and psychological distress. Results: Results showed that in all three solutions the clusters were defined by increasing total symptom scores and increasing psychological distress. Cluster-specific symptom patterns where evident only when more clusters (three or four) were allowed. The best fit index was found for a 2-cluster solution. Conclusion: The finding of symptom specific patterns in clusters which could not be differentiated on overall symptom severity is in favor of the splitters' view. The finding that all other clusters could be discriminated on overall symptom severity and that the 2-cluster solution had the best fit is in favor of the lumpers' view.
AB - Objective: The aim of the present study was to address the lumper-splitter discussion on functional somatic syndromes by applying k-means cluster analyses on a heterogeneous sample of persons with unexplained somatic complaints. In favor of the lumper-side of the debate, clusters should differ only on the overall severity of the somatic complaints that were assessed. According to the splitters view, clusters should differ in symptom-specific patterns. Methods: Three-hundred ninety four subjects with functional somatic symptoms were clustered based on their scores on 47 somatic symptoms. Three cluster solutions (k=2,3, and 4 clusters) were compared on overall symptom severity, symptom patterns, and psychological distress. Results: Results showed that in all three solutions the clusters were defined by increasing total symptom scores and increasing psychological distress. Cluster-specific symptom patterns where evident only when more clusters (three or four) were allowed. The best fit index was found for a 2-cluster solution. Conclusion: The finding of symptom specific patterns in clusters which could not be differentiated on overall symptom severity is in favor of the splitters' view. The finding that all other clusters could be discriminated on overall symptom severity and that the 2-cluster solution had the best fit is in favor of the lumpers' view.
KW - Cluster analysis
KW - Functional somatic symptoms
KW - Medically unexplained symptoms
KW - Psychological distress
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U2 - 10.1016/j.jpsychores.2012.09.013
DO - 10.1016/j.jpsychores.2012.09.013
M3 - Article
C2 - 23272982
AN - SCOPUS:84871693072
SN - 0022-3999
VL - 74
SP - 6
EP - 11
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
IS - 1
ER -