Background: Functional somatic symptoms (FSS), symptoms that cannot be conclusively explained by organic pathology, have a poorly understood aetiology. Our aim is to study intelligence as a risk factor for FSS. We hypothesize that intelligence is negatively associated with the number of FSS. To investigate the specific role of intelligence in FSS as opposed to medically explained symptoms (MES), we compared associations of intelligence with FSS with those of intelligence with MES. We hypothesize that lifestyle factors and socioeconomic factors mediate the relation between intelligence and both FSS and MES, whereas psychological distress is especially important for FSS.
Methods: We performed all analyses in a longitudinal study with two measurement waves in a general population cohort of 947 participants (age 33-79 years, 47.9 % male). We used the Generalized Aptitude-Test Battery to derive an index for general intelligence, and the somatization section of the Composite International Diagnostic Interview to measure the number of FSS and MES.
Results: General intelligence was significantly associated with the number of FSS. The association of intelligence and FSS but not MES was mediated by work-situation: participants of lower intelligence that report more FSS are more often (unwanted) economically inactive. No evidence was found for a mediating role of psychological distress in the association of intelligence with FSS, even though distress was an important predictor of FSS.
Conclusion: Intelligence is negatively associated with the number of FSS in the general population. Part of the association of intelligence with FSS is explained by a more unfavourable work situation of adults of lower intelligence.
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