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Genetic and Environmental Contributions to the Overlap Between Psychological, Fatigue and Somatic Symptoms: A Twin Study in Sri Lanka

Published online by Cambridge University Press:  21 February 2012

Harriet A. Ball*
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, United Kingdom. harriet.ball@kcl.ac.uk
Sisira H. Siribaddana
Affiliation:
Sri Lanka Twin Registry, Institute of Research and Development, Battaramulla, Sri Lanka.
Athula Sumathipala
Affiliation:
Sri Lanka Twin Registry, Institute of Research and Development, Battaramulla, Sri Lanka; Section of Epidemiology, Institute of Psychiatry, Kings College London, United Kingdom.
Yulia Kovas
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, United Kingdom; Goldsmiths, University of London, London, United Kingdom.
Nick Glozier
Affiliation:
Sydney Medical School, University of Sydney, Australia; Department of Psychological Medicine, Institute of Psychiatry, Kings College London, United Kingdom.
Frühling Rijsdijk
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, United Kingdom.
Peter McGuffin
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, United Kingdom.
Matthew Hotopf
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Kings College London, United Kingdom.
*
*Address for correspondence: Dr Harriet A. Ball, MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, SE5 8AF, UK.

Abstract

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Background: Somatic symptoms often co-occur with psychological symptoms but this overlap is poorly understood. Some aspects of this overlap differ in the South Asian context, but it is not clear whether this is a reporting effect or an underlying difference in experienced illness. Methods: Home interviews were administered to 4,024 twins randomly selected from a population-based twin register in the Colombo district of Sri Lanka (the CoTASS study). These included assessments of psychological, somatic and fatigue symptoms. The data were analyzed using factor analytic and quantitative genetic approaches. Results: Confirmatory factor analysis showed that the symptoms from the three scales represented three separate dimensions, rather than all tapping into a single dimension. However, familial correlations among the data were most consistent with a common pathway model. This implies that a portion of the underlying vulnerability is common across psychological, fatigue and somatic symptoms. There were sex differences in the etiology of this model, with shared environmental and genetic influences playing different roles in men and women. Conclusions: There is a complex etiological relationship between psychological, fatigue and somatic symptoms. This is similar in Sri Lanka to Western countries, but there may be a greater influence from the family environment, suggesting that care needs to be taken when generalizing research findings between countries. People who complain of certain fatigue or somatic symptoms may well also have psychological symptoms, or may have genetic or environmental vulnerabilities to such problems.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011