Beyond symptoms: Course and mechanisms of persistent somatic symptoms

The occasional experience of somatic symptoms – such as feeling tired, having a headache or backpain- is a common phenomenon. Although symptoms often resolve, sometimes they become persistent and disabling. The research in this thesis addresses these persistent somatic symptoms (PSS) in adult patients who repeatedly visit their GP or are referred to a specialized treatment facility for their PSS. Long-term follow-up studies on the course and prognosis of PSS are scarce, and empirical knowledge about mechanisms that may play a role as perpetuating factors in the perceived burden of PSS over time remains limited. Therefore, the main aim of the research presented in this thesis is to increase scientific knowledge about the course and mechanisms of PSS. The PROSPECTS study, a prospective cohort study of adult patients with PSS, forms the backbone of this thesis.