Multiple physical symptoms and coping strategies over the last decade - Knowledge from two Danish population-based cross-sectional studies in 2012 and 2022

Objective: To compare the prevalence of multiple physical symptoms, coping scores, and associations between multiple physical symptoms and coping in two population-based surveys within a 10-year interval. Methods: A nationwide study on symptoms and healthcare-seeking, the Danish Symptom Cohort, was carried out in 2012 and repeated in 2022. For each survey, 100,000 randomly selected individuals were invited, and individuals aged 20 -64 years were eligible for inclusion. Multiple physical symptoms were identified using the 25item Bodily Distress Syndrome checklist, and coping was assessed with the Brief Approach/Avoidance Coping Questionnaire. Statistical analyses included multinomial and logistic regressions. Results: A total of 35,877 were included in 2012 and 18,330 in 2022. Overall, 35.1% reported multiple physical symptoms in 2022 compared with 23.8% in 2012. The mean sum score for approach was lower in 2022 than in 2012 with a statistically significant mean difference of-1.27 (Cohen's d =-0.34), while diversion and resignation scores were significantly higher in 2022 with mean differences of 0.34 (Cohen's d = 0.11) and 0.52 (Cohen's d = 0.17), respectively. Regression analyses showed that lower approach scores and higher diversion and resignation scores were associated with an increased probability of having multiple physical symptoms in 2022, thereby confirming the results from 2012. Conclusion: Over the decade, symptom reporting may have increased while coping strategies may have changed towards a slightly higher use of avoidance and lower use of approach. It seems relevant to identify modifiable contributing factors in society to prevent an acceleration of symptom reporting and avoidant behavior.