BACKGROUND: Functional somatic symptoms (FSS), like chronic pain and overtiredness, are often assumed to be stress-related. Altered levels of the stress hormone cortisol could explain the association between stress and somatic complaints. We hypothesized that low cortisol levels after awakening and low cortisol levels during stress are differentially associated with specific FSS. METHODS: This study is performed in a subsample of TRAILS (Tracking Adolescents' Individual Lives Survey) consisting of 715 adolescents (mean age: 16.1 years, SD=0.6, 51.3% girls). Adolescents' cortisol levels after awakening and during a social stress task were assessed. The area under the curve with respect to the ground (AUCg) and the area under the curve above the baseline (AUCab) were calculated for these cortisol levels. FSS were measured using the Youth Self-Report and pain questions. Based upon a factor analysis, FSS were divided into two clusters, one consisting of headache and gastrointestinal symptoms and the other consisting of overtiredness, dizziness and musculoskeletal pain. RESULTS: Regression analyses revealed that the cluster of headache and gastrointestinal symptoms was associated with a low AUCg of cortisol levels during stress (β=-.09, p=.03) and the cluster of overtiredness, dizziness and musculoskeletal pain with a low AUCg of cortisol levels after awakening (β=-.15, p=.008). All these analyses were adjusted for the potential confounders smoking, physical activity level, depression, corticosteroid use, oral contraceptive use, gender, body mass index and, if applicable, awakening time. CONCLUSION: Two clusters of FSS are differentially associated with the stress hormone cortisol.
BACKGROUND: Functional somatic symptoms (FSS), like chronic pain and overtiredness, are often assumed to be stress-related. Altered levels of the stress hormone cortisol could explain the association between stress and somatic complaints. We hypothesized that low cortisol levels after awakening and low cortisol levels during stress are differentially associated with specific FSS. METHODS: This study is performed in a subsample of TRAILS (Tracking Adolescents' Individual Lives Survey) consisting of 715 adolescents (mean age: 16.1 years, SD=0.6, 51.3% girls). Adolescents' cortisol levels after awakening and during a social stress task were assessed. The area under the curve with respect to the ground (AUCg) and the area under the curve above the baseline (AUCab) were calculated for these cortisol levels. FSS were measured using the Youth Self-Report and pain questions. Based upon a factor analysis, FSS were divided into two clusters, one consisting of headache and gastrointestinal symptoms and the other consisting of overtiredness, dizziness and musculoskeletal pain. RESULTS: Regression analyses revealed that the cluster of headache and gastrointestinal symptoms was associated with a low AUCg of cortisol levels during stress (β=-.09, p=.03) and the cluster of overtiredness, dizziness and musculoskeletal pain with a low AUCg of cortisol levels after awakening (β=-.15, p=.008). All these analyses were adjusted for the potential confounders smoking, physical activity level, depression, corticosteroid use, oral contraceptive use, gender, body mass index and, if applicable, awakening time. CONCLUSION: Two clusters of FSS are differentially associated with the stress hormone cortisol.
Authors: Albertine J Oldehinkel; Judith Gm Rosmalen; Jan K Buitelaar; Hans W Hoek; Johan Ormel; Dennis Raven; Sijmen A Reijneveld; René Veenstra; Frank C Verhulst; Wilma Am Vollebergh; Catharina A Hartman Journal: Int J Epidemiol Date: 2014-11-26 Impact factor: 7.196
Authors: Karin A M Janssens; Harriëtte Riese; Arie M Van Roon; Joke A M Hunfeld; Paul F C Groot; Albertine J Oldehinkel; Judith G M Rosmalen Journal: PLoS One Date: 2016-04-18 Impact factor: 3.240
Authors: Karen Hansen Kallesøe; Andreas Schröder; Rikard K Wicksell; Per Fink; Eva Ørnbøl; Charlotte Ulrikka Rask Journal: BMJ Open Date: 2016-09-15 Impact factor: 2.692
Authors: Jianzhong Su; Ying Du; Kelley Bevers; Pengcheng Xiao; John Licciardone; Marco Brotto; Robert J Gatchel Journal: J Transl Med Date: 2019-09-06 Impact factor: 5.531
Authors: Markus Paananen; Peter O'Sullivan; Leon Straker; Darren Beales; Pieter Coenen; Jaro Karppinen; Craig Pennell; Anne Smith Journal: Arthritis Res Ther Date: 2015-12-10 Impact factor: 5.156