Background: Persistent physical symptoms (PPS) can significantly impair health-related quality of life (HRQoL) and are often accompanied by psychiatric comorbidity. Psychological flexibility (PF), characterized by the ability to adapt functionally and congruently to diverse situations based on personal values, may play a crucial role in determining HRQoL. This study aims to examine the associations between symptoms of depression, anxiety or insomnia or PF and HRQoL among individuals with PPS associated with (i) the indoor environment (IE), (ii) chronic fatigue, or (iii) both.
Methods: We utilized the baseline data (n = 103) from a randomized controlled trial focused on improving the HRQoL of individuals (mean age 46.1, SD 7.8, 86% women) experiencing PPS associated with IE or chronic fatigue. Self-report questionnaires were administered to evaluate symptoms of depression, anxiety, insomnia, and dimensions of PF, including acceptance, cognitive fusion, and thought suppression. The primary outcome was HRQoL, assessed using a 15D questionnaire. The association between symptoms, PF dimensions, and HRQoL was examined using Pearson's correlation and ANCOVA.
Results: Symptoms of depression, anxiety, and insomnia were negatively associated with HRQoL (p <.001) across all participants. Among individuals with PPS associated with IE, higher PF was significantly associated with higher HRQoL. No association was found between PF and HRQoL in those with chronic fatigue-associated PPS or both conditions.
Conclusions: PF associated with positive outcomes in HRQoL in individuals with PPS associated with the indoor environment, but not in those with chronic fatigue. Further research on the differences between these groups is warranted to enhance treatment targeting.
Trial Registration: Clinicaltrials.gov NCT04532827 (registered 26.08.2020).
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