Leg symptoms of somatic, psychic, and unexplained origin in the population-based Bonn vein study.

Abstract

To assess the somatic and psychic components of venous-type leg symptoms. The psychic versus somatic venous disease questionnaire (PsySoVDQ) was applied to 1,800 participants of the Bonn Vein Study (BVS) II. Factor analysis of the PsySoVDQ made it possible to distinguish a psychic component (PC; 5 items, Cronbach's alpha = 0.73) separate from a somatic component (SC; 4 items, Cronbach's alpha = 0.67). The PC reflected anxiety and inhibition, was prevalent in 39.8% and explained 7.3% of the BVS findings. Higher PC scores were typically found in younger, slim women of higher social status, with feelings of leg heaviness and tension, and reduced psychic quality of life. The SC prevailed in 37.4% and explained 16.5% of BVS findings. Typical SC scorers were older, overweight women with lower social status, more symptoms (including swelling), signs of chronic venous insufficiency, ultrasound-documented venous abnormalities, and reduced multidimensional quality of life. The SC's predictive accuracy for CEAP 2 and 3 (classification according to clinical findings, etiology, anatomy, pathophysiology) was equal to that of the BVS assessment. The PsySoVDQ identified somatic and psychic components of the widespread and frequently reported leg symptoms in the general population. Nevertheless, in the majority of subjects symptoms remained unexplained. A neuropsychological and neurobiological hypothesis is advanced.