Dysfunction of stress responsive systems as a risk factor for functional somatic syndromes

Lineke M. Tak, Judith G. M. Rosmalen*

*Corresponding author for this work

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Abstract

The etiology of functional somatic syndromes or disorders (FSDs) is generally considered to be a multifactorial interplay between psychological, biological, and social factors. One of the most investigated biological factors is stress responsive system dysfunction Despite more than twenty years of research of the autonomic nervous system and the hypothalamic-pituitary-adrenal axis, however, it is yet unknown whether dysfunctions in these systems play a causal role in the etiology of FSDs and whether they are generic or FSD-specific. In this review, we will give an overview of available evidence on whether or not alterations in these stress responsive systems can be considered causal risk factors of FSDs. We conclude that although not necessary factors for FSDs in general, lowered cardiac vagal activity and hypocortisolism may be pivotal in the etiology and treatment strategy in subgroups of subjects with a FSD Such subgroups need to be better identified. (C) 2010 Elsevier Inc All rights reserved.

Original languageEnglish
Pages (from-to)461-468
Number of pages8
JournalJournal of Psychosomatic Research
Volume68
Issue number5
DOIs
Publication statusPublished - May-2010

Keywords

  • Autonomic nervous system
  • Functional somatic symptoms
  • Hypothalamus-pituitary-adrenal axis
  • Somatoform
  • Stress
  • Functional somatic syndromes
  • HEART-RATE-VARIABILITY
  • CHRONIC-FATIGUE-SYNDROME
  • MEDICALLY UNEXPLAINED SYMPTOMS
  • RANDOMIZED CONTROLLED-TRIAL
  • AUTONOMIC NERVOUS-SYSTEM
  • LOW-DOSE HYDROCORTISONE
  • SOMATOFORM DISORDERS
  • CORTISOL RESPONSE
  • SALIVARY CORTISOL
  • CROSSOVER TRIAL

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