To Label or Not to Label, That Is the Question: Investigating diagnostic labelling in functional somatic disorders

Functional Somatic Disorders (FSD) encompass conditions such as fibromyalgia (FM), chronic fatigue syndrome (CFS), and irritable bowel syndrome (IBS), which present persistent physical symptoms without identifiable biomedical abnormalities. FSDs significantly impact patients’ quality of life (QoL) and healthcare utilization. Despite established diagnostic criteria, many individuals fulfilling these criteria do not receive a formal FSD diagnosis. This thesis explores the implications of receiving an FSD diagnostic label and the factors influencing this process.
A systematic review synthesized evidence from 15 studies, revealing gender disparities in FSD labelling and its mixed effects on patients. While diagnosis provided initial relief, it was often followed by concerns over chronicity and social stigma. Population-based studies in Denmark and the Netherlands found that most individuals meeting FSD diagnostic criteria did not receive a formal label. Labelling was associated with female sex, worse QoL, lower education, psychiatric comorbidities, and higher healthcare use, though other associations varied.
A qualitative study examined the lived experiences of FM patients, highlighting profound changes in self-perception, social relationships, and occupational roles post-diagnosis. Lastly, an analysis of Wikipedia content demonstrated inconsistencies in online information quality and widespread stigma surrounding FSD.
This thesis investigates the complex and multifaceted nature of FSD labelling, emphasizing the need for further research to better understand its consequences and improve patient care.