The course of persistent somatic symptoms and underlying mechanisms, a long-term follow-up study

In all healthcare settings, patients frequently present with somatic symptoms for which no sufficient somatic explanation is found after adequate medical examination. Such symptoms are often called ‘medically unexplained symptoms’ (MUS), or, more recently, ‘persistent somatic symptoms’ (PSS). In most cases, these symptoms are self-limiting. However, when they persist, they can be severe and disabling. PSS are associated with functional impairment, psychological distress and extensive use of health care services. Little is known about the long-term course of PSS. Currently there are different theoretical models for the etiology of PSS, however: empirical foundation for these models is scarce. To gain more knowledge about the course and etiological factors of importance, the PROSPECTS study was started in 2013. The PROSPECTS study is a longitudinal prospective cohort study of patients with PSS. In this project (PROSPECTS-2), we extended the study follow-up to five years. The main aim is to analyze 5-year trajectories of PSS and identify prognostic factors for the various trajectories. In addition, we aim to examine three possible mechanisms for PSS and to explore patients’ experiences with fluctuations in PSS.