An investigation of discordance between subjective and physiological measures of vasomotor symptoms

Abstract

Objectives Hot flushes and night sweats (HF/NS) can be measured objectively using sternal skin conductance (SSC) monitoring, but objective and subjective measures of HF/NS have only moderate concordance. We aim to investigate this discordance and factors affecting perceptions of HF/NS in a UK sample.

Methods Twenty-seven menopausal women completed questionnaires assessing beliefs about HF/NS, mood, stress, somatic amplification and subjective (frequency and problem-rating) and objective (24-h SSC) HF/NS measures.

Results On average, 48 HF/NS were reported per week; 47%% of objectively recorded HF/NS were accompanied by a subjective response and 56%% of subjectively recorded HF/NS were accompanied by an objective recording. Concordant HF/NS were more likely to be moderate or severe, while over-reported (false-positive) HF/NS tended to be mild or moderate; night sweats were more likely to be under-reported. Anxiety, somatic amplification and body mass index were associated with negative beliefs about HF/NS and, in turn, negative beliefs were associated with more problematic HF/NS.

Conclusions Different patterns of discordance were evident for hot flushes and night sweats. Both subjective and objective measures should be included in the evaluation of treatments for HF/NS. The possible role of beliefs in mediating the influence of anxiety, somatic amplification and body mass index upon HF/NS experience warrants further investigation.

Key words:

• HOT FLUSHES
• NIGHT SWEATS
• VASOMOTOR SYMPTOMS
• MENOPAUSAL SYMPTOMS
• STERNAL SKIN CONDUCTANCE
• SYMPTOM PERCEPTION
• BELIEFS
• MOOD

Acknowledgements

We would like to acknowledge the assistance of Gloria Tresaco and Arron Cook in data collection.

Conflict of interest  The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper.

Source of funding  The study was supported by the NIHR Biomedical Research Centre for Mental Health, the South London and Maudsley NHS Foundation Trust, and the Institute of Psychiatry, King's College London.