2 Jan. 2022

TOPIC: Persistent physical symptoms

Persistent somatic symptoms are long term symptoms that lack a clear medical explanation. These symptoms have a high prevalence where most people know someone who experiences such symptoms or they experience such symptoms themselves. Symptoms can vary greatly in and between people. While one person may experience fatigue, another may have chronic pain, headaches, an irritable bowel, or dizziness – the list is endless. Factors that may contribute to the onset and/or persistence of persistent somatic symptoms also vary greatly and generally cannot be attributed to one single factor. Because these symptoms cannot be attributed to an actual physical ailment, doctors often find it difficult to help patients experiencing these symptoms. This research line focuses on increasing the knowledge on factors that contribute to the onset or persistence of these symptoms, developing ways to recognize patients at risk of persistent problems, and improving treatment for this patient group.


At least 10% of the general population experiences persistent somatic symptoms (PSS). PSS – symptoms without identified biomedical pathology – are prevalent in both patients with well-understood disorders, such as cancer and cardiovascular disease, as well as in patients without well-understood disorders. Due to diagnostic difficulties and delays, PSS are generally accompanied by an increasing burden of disease for both the patient and the health care system. Terminology and classification for PSS vary widely across and within health care domains. While umbrella terms such as medically unexplained (physical) symptoms, functional somatic symptoms and PSS are used interchangeably, symptoms may also be classified as syndromes which cluster around bodily symptoms (such as, fibromyalgia, chronic fatigue syndrome, or irritable bowel syndrome).

In our department, we aim to focus on improving health care for patients with PSS. This is done by investigating factors contributing to the onset and course of PSS, the development of tools to identify patients at an early stage – e.g., by utilizing routine primary care data, as well as testing preexisting interventions – e.g., cognitive behavioral therapy – and investigating new treatment techniques – e.g., how can we use placebo effects to the benefit of patients with PSS? – for PSS. The studies in our department not only focus on the broad range of PSS, but are also directed more specifically at syndromes such as fibromyalgia and chronic fatigue syndrome. To get a clear picture, our research is both patient – e.g., what health domains contribute to the onset of PSS? – and doctor – e.g., how do doctors communicate with patients with fibromyalgia about their symptoms? – focused.

In our efforts to contribute to improving health care for patients with PSS, we combine conventional (e.g., surveys and self-report questionnaires) and innovative methodologies (e.g., artificial intelligence, experimental pain measurements), and we work in a multidisciplinary manner with LUBEC (academic treatment and expert center) and LUMC-Campus the Hague (population health management).


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