Chronic pain (CP) is a multifaceted and severely disabling persistent condition that affects individuals worldwide. A synthesis of epidemiological data is still lacking. The present systematic review aims at presenting point, period, and lifetime prevalence estimates of CP in the European adult population, as well as relevant features associated with it. Following PRISMA guidelines, a systematic search in PubMed, Web of Science, Embase, and Cochrane library was run from inception to May 2024, resulting in 39,832 hits. Among those, 132 full-text articles were assessed, and 23 studies comprising 862,013 participants with CP were included. The Joanna Biggs Institutes' Critical Appraisal Checklist for Studies Reporting Prevalence Data (JBI) was used for quality assessment. Findings showed a point prevalence ranging from 12% to 48%, a 6-month prevalence of 17.5% to 49.8%, a 12-month prevalence ranging from 8.1% to 44.6%, and a lifetime prevalence ranging from 12.7% to 33.7% independently from sex. Sociodemographic factors (eg, female sex, higher age, no partnership, lower education, unemployment) and clinical features (eg, medical diseases, mental disorders and burdens, healthcare utilization, functional impairment) were identified as being associated with CP. The variability in prevalence estimates can be reduced by applying consistent diagnostic criteria (eg, ICD-11) and by using standardized assessment tools (eg, scales, clinical interview). The high prevalence and the characteristics of the associated features support the need for adequate, multicomponent care paths to manage CP based on a comprehensive biopsychosocial model.

Introduction: Persistent medically unexplained symptoms (MUS) are a major burden for health care. Cognitive behaviour therapy (CBT) is efficacious for patients with MUS, with small to medium effects. The current study investigates whether therapy outcomes of a CBT for MUS patients can be improved by complementing it with emotion regulation training. Methods: In a multicentre trial 255 patients with at least three persisting MUS were randomised to 20 sessions of either conventional CBT (n = 128) or CBT complemented with emotion regulation training (ENCERT; n = 127). Somatic symptom severity and secondary outcomes were assessed at pre-treatment, therapy session 8, end of therapy, and 6-month follow-up. Results: Linear mixed-effect models revealed medium to large effects in both study arms for almost all outcomes at the end of therapy and 6-month follow-up. ENCERT and CBT did not differ in their effect on the primary outcome (d = 0.20, 95% CI: –0.04 to 0.44). Significant time × group cross-level interactions suggested ENCERT to be of more benefit than conventional CBT for a few secondary outcomes. Moderator analyses revealed higher effects of ENCERT in patients with co-morbid mental disorders. Discussion/Conclusions: Current findings are based on a representative sample. Results demonstrate that both CBT and ENCERT can achieve strong effects on primary and secondary outcomes in MUS patients. Our results do not indicate that adding a training in emotion regulation skills generally improves the effect of CBT across all patients with MUS. Large effect sizes of both treatments and potential specific benefits of ENCERT for patients with co-morbid mental disorders are discussed.

Functional Disorders (FD) refer to persistent somatic symptoms caused by changes in the functioning of bodily processes. Previous findings suggest that FD are highly prevalent, but overall prevalence rates for FD in European countries are scarce. Therefore, the aim of the present work was to estimate the point prevalence of FD in adult general populations. PubMed and Web of Science were searched from inception to June 2022. A generalized linear mixed-effects model for statistical aggregation was used for statistical analyses. A standardized quality assessment was performed, and PRISMA guidelines were followed. A total of 136 studies were included and systematically synthesized resulting in 8 FD diagnoses. The large majority of studies was conducted in the Northern Europe, Spain, and Italy. The overall point prevalence for FD was 8.78% (95% CI from 7.61 to 10.10%) across Europe, with the highest overall point prevalence in Norway (17.68%, 95% CI from 9.56 to 30.38%) and the lowest in Denmark (3.68%, 95% CI from 2.08 to 6.43%). Overall point prevalence rates for specific FD diagnoses resulted in 20.27% (95% CI from 16.51 to 24.63%) for chronic pain, 9.08% (95% CI from 7.31 to 11.22%) for irritable bowel syndrome, and 8.45% (95% CI from 5.40 to 12.97%) for chronic widespread pain. FD are highly prevalent across Europe, which is in line with data worldwide. Rates implicate the need to set priorities to ensure adequate diagnosis and care paths to FD patients by care givers and policy makers.

Zusammenfassung. Theoretischer Hintergrund: Die Fatigue Skala (FS) stellt ein international verbreitetes Instrument zur Diagnostik anhaltender Erschöpfungszustände dar. Fragestellung: Ziel zweier Studien war die psychometrische Überprüfung der deutschen FS. Methode: Rekrutiert wurden 2510 Personen der deutschen Allgemeinbevölkerung und 100 Patienten aus klinisch-therapeutischen Einrichtungen, um die FS und weitere Skalen (SOMS-7T, WHO-5, SF-8, FAQ) zu bearbeiten. Bestimmt wurden Reliabilität, konvergente (Studien 1, 2), faktorielle Validität und Normwerte (Studie 1). Ergebnisse: Es zeigten sich hohe interne Konsistenzen und sehr gute Retest-Reliabilität (24h) der Gesamtskala, Bestätigung der Zweifaktorenstruktur, mittlere Zusammenhänge von Fatigue mit somatoformen Beschwerden, Wohlbefinden und Lebensqualität sowie eine hohe Übereinstimmung mit Erschöpfung, erfasst mittels Alternativtest. Schlussfolgerungen: Die FS erscheint bei guten bis sehr guten psychometrischen Charakteristika für den diagnostischen E... The assessment of chronic fatigue: psychometric properties of the Fatigue Scale (FS) Background: The Fatigue Scale (FS) is a widely used instrument to assess severity and symptoms of chronic fatigue. Objective: The aim of the present studies consisted in the psychometric foundation of the German version of the FS. Methods: A total of N = 2510 of the German population (study 1) and N = 100 patients with psychosomatic/mental disorders (study 2) filled in the FS and additional scales (SOMS-7T, WHO-5, SF-8, FAQ). Results showed high internal consistency and retest-reliability of the fatigue severity score, confirmation of the 2-factor-structure and associations between fatigue and somatoform symptoms, well-being and quality-of-life. Conclusions: Based on its psychometric properties the FS seems to be an adequate instrument for the individual assessment and treatment evaluation of chronic fatigue.