What is the role of interoception in the symptom experience of people with a chronic condition? A systematic review.

Background: Interoception, the ability of the organism to sense, interpret, and regulate signals originating from within the body, plays an important role in how individuals perceive and respond to symptoms. However, there is scarce evidence on the role of interoception in the symptom experience of people with chronic conditions.

Aim: To synthesize the role of interoception in the symptom experience of adults with a chronic condition.

Methods: Systematic review. We searched PubMed, Psychinfo, Embase, CINAHL, and Science Citation Index-Expanded. We included primary research (all study designs) addressing our study aim, published between 2013 and 2021, and measuring at least one dimension of interoception. Any chronic condition and any symptom were included. No language limits were applied. Only the adult population was included.

Results: We included 18 quantitative studies investigating the relationship between three interoceptive dimensions (i.e., accuracy, sensibility, awareness) and condition-specific symptoms in 8 chronic conditions. People with chronic conditions had lower interoceptive accuracy than healthy controls. Higher interoceptive sensibility was associated with lower symptom severity/frequency. Higher interoceptive accuracy was associated with lower symptom severity/frequency in half of the studies, while the other half reported the opposite. Only one study explored interoceptive awareness.

Conclusion: Interoceptive accuracy is lower in patients with chronic conditions. Higher interoceptive sensibility is associated with lower symptom severity/frequency, but this relationship is unclear when it comes to interoceptive accuracy and awareness.