Somatic burden in Russia during the COVID-19 pandemic

Alena Zolotareva; Anna Khegay; Elena Voevodina; Igor Kritsky; Roman Ibragimov; Nina Nizovskih; Vsevolod Konstantinov; Arina Malenova; Irina Belasheva; Natalia Khodyreva; Vladimir Preobrazhensky; Kristina Azanova; Lilia Sarapultseva; Almira Galimova; Inna Atamanova; Anastasia Kulik; Yulia Neyaskina; Maksim Lapshin; Marina Mamonova; Ruslan Kadyrov; Ekaterina Volkova; Viktoria Drachkova; Andrey Seryy; Natalia Kosheleva; Evgeny Osin

doi:10.1371/journal.pone.0282345

Peer Review History

Original SubmissionJuly 5, 2022
17 Oct 2022 Decision Letter - Ahmet Murt, Editor PONE-D-22-18719Somatic burden in Russia during the COVID-19 pandemicPLOS ONE Dear Dr. Zolotareva, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Dec 01 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Ahmet Murt Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. 3. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: I think it is a good article evaluating the somatic burden. Minor Points - In Table 1, I think that it is not necessary to give all the cities where the participants in the study live. The table seems too long. - Table 1 presents data on the results of the Fear of COVID-19 Scale and the СOVID-19 Preventive Behavior Index. Therefore, it would be more appropriate to give Table 1 after the explanations of these scales. -Typos should be corrected. Reviewer #2: In this article, authors have researched the somatic burden of Russian population during COVID-19 pandemic. The scales and number of participants are acceptable. However, the paper needs some modifications before it can proceed to the publication stage: 1- Why didn't the authors exclude any patients with any previous psychological or psychiatric illnesses? 2- Do we have any information about previous health problems of the participants? There might appear a difference between those who have and those who don't have. 3- In somatic symptom scale, authors state that there are 4 levels of symptoms: minimal, low, medium, high, very high. However in latent profiles there are only low, medium and high levels. Can the authors explain why they reduced the number of profile classes?( (It's stated that goodness for fit model does not indicate the superiority of any other) 4- Although females are given and discussed as higher somatizers, it is said in associated factors of somatic burden that 'low somatisers were more often females'. This should be corrected. 5- Authors should explain their selection criteria for the multinomial regression model. 6- May authors also discuss the reasons for differences between different cities or regions? Do any of these regions have any specific characteristics? ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0282345.r001
Revision 1
4 Nov 2022 Author Response Dear Reviewers, Thank you for your help in improving our manuscript. We have made the modifications following your suggestions: In Table 1, I think that it is not necessary to give all the cities where the participants in the study live. The table seems too long. Thank you, for brevity we have excluded the list of cities from Table 1. Table 1 presents data on the results of the Fear of COVID-19 Scale and the СOVID-19 Preventive Behavior Index. Therefore, it would be more appropriate to give Table 1 after the explanations of these scales. Thank you for these suggestions, we moved Table 1 to the Results section, so that readers can see the descriptive statistics for these instruments after they read their descriptions in Methods. Typos should be corrected. Thank you for this suggestion. We have proofread the manuscript and had the text proofread by a native English-speaking editor who used British spelling. Why didn't the authors exclude any patients with any previous psychological or psychiatric illnesses? Indeed, we did not specifically exclude patients with any prior psychological or psychiatric illnesses for several reasons. Firstly, The Somatic Symptom Scale-8 used in our study fairly accurately assesses the DSM-5 somatic symptom disorder (AUC = 0,71; 95% CI = 0,66-0,77, according to Toussaint et al., 2020). This implies that more than a third of our sample (37% of participants) meet the criteria for somatic symptom disorder. Moreover, a meta-analytic review has shown that at least a third of patients with somatoform disorders have comorbid anxiety and depressive disorders (Henningsen et al., 2003). Given this, somatic symptoms and mental disorders emerge as quite difficult to differentiate, and we believe that doing it would make the sample of individuals with somatic symptoms less representative. Secondly, our study was carried out in an online setting, where we could not be sure that the participants would objectively assess their psychological state or honestly report a psychiatric diagnosis. And, finally, there is evidence indicating that many disorders are diagnosed in Russia extremely rarely: for instance, only 1-4% of cases of bipolar affective disorder, depression, anxiety disorders are diagnosed by specialists (Martynikhin, 2021): as a result, most Russian participants with mental comorbidities would probably never be aware of the fact. However, we totally agree with you that excluding patients with a history of psychiatric illnesses could affect our findings and we described this as a limitation of the current study (“The online survey limits our ability to highlight possible physiological causes of reported somatic symptoms, which may be associated with mental and physical disorders”) and a prospect for future research (“Future studies should rely on objective characteristics (medical records, laboratory tests, physician evaluations, etc.)”). Henningsen P., Zimmermann T., Sattel H. (2003). Medically unexplained physical symptoms, anxiety, and depression: a meta-analytic review. Psychosomatic Medicine, 65, 528–533. https://doi.org/10.1097/01.psy.0000075977.90337.e7 Martynikhin, I. A. (2021). The use of ICD-10 for diagnosing mental disorders in Russia, according to national statistics and a survey of psychiatrists’ experience. Consortium Psychiatricum, 2(2), 35-44. https://consortium-psy.com/jour/article/view/69/pdf Toussaint A., Hüsing P., Kohlmann S., & Löwe B. (2020). Detecting DSM-5 somatic symptom disorder: criterion validity of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder – B Criteria Scale (SSD-12). Psychological Medicine 50, 324–333. https://doi.org/10.1017/S003329171900014X Do we have any information about previous health problems of the participants? There might appear a difference between those who have and those who don't have. Our questionnaire contained only one question about the respondents' objective health status ("Do you think you were sick with COVID-19?"). We did not ask about chronic illnesses and other possible medical causes of somatic symptoms for the same reasons as we did not ask about psychiatric illnesses. We agree that this is a very serious question and we also noted this in the Limitations section: “” In somatic symptom scale, authors state that there are 4 levels of symptoms: minimal, low, medium, high, very high. However in latent profiles there are only low, medium and high levels. Can the authors explain why they reduced the number of profile classes? (It's stated that goodness for fit model does not indicate the superiority of any other). The authors of the Somatic Symptom Scale-8 distinguish five levels of somatic burden: minimal, low, medium, high, and very high (Gierk et al., 2013). In choosing the number of latent profiles, we relied on a combination of information criteria, entropy, and interpretability of the resulting classes. In particular, the 5-profile model had higher AIC and BIC values, suggesting that this number of profiles is excessive. Based on a combination of theoretical and empirical considerations, in line with some existing studies (Burri et al., 2017; Eliasen et al., 2018; Kato et al., 2010), we opted for a 3-profile model that, as we believe, is parsimonious and at the same time sufficiently theoretically clear. Burri A, Hilpert P, McNair P, Williams FM. Exploring symptoms of somatization in chronic widespread pain: Latent class analysis and the role of personality. J. Pain Res. 2017; 10:1733–1740. https://doi.org/10.2147/JPR.S139700 Eliasen M, Schröder A, Fink P, Kreiner S, Dantoft TM, Poulsen CH, et al. A step towards a new delimitation of functional somatic syndromes: A latent class analysis of symptoms in a population-based cohort study. J. Psychosom. Res. 2018; 108:102–117. https://doi.org/10.1016/j.jpsychores.2018.03.002 Gierk B., Kohlmann S., Kroenke K., Spangenberg L., Zenger M., Brähler E., et al. The somatic symptom scale-8 (SSS-8): A brief measure of somatic symptom burden. JAMA Internal Meicine, 174(3), 399–407. https://doi.org/10.1001/jamainternmed.2013.12179 Kato K, Sullivan PF, Pedersen NL. Latent class analysis of functional somatic symptoms in a population-based sample of twins. J. Psychosom. Res. 2010; 68(5):447–453. https://doi.org/10.1016/j.jpsychores.2010.01.010 Although females are given and discussed as higher somatizers, it is said in associated factors of somatic burden that 'low somatisers were more often females'. This should be corrected. Thank you so much for helping us see and correct this mistake, which was a typo. While proofreading the text, we found another similar mistake in the description of the latent profiles (‘more frequently reported history of COVID-19 disease’ instead of ‘more rarely reported history of COVID-19 disease’). All errors have been corrected. Authors should explain their selection criteria for the multinomial regression model. We tried to explain selection criteria for the multinomial regression model by adding the following sentence to the Introduction: ‘Specifically, we presumed that somatic burden during the COVID-19 pandemic is associated with known pre-pandemic risk factors (female gender, older age, not being in a partnership, lower education background) [18; 19; 20], but is more dependent on health- and pandemic-related risk factors (poorer self-rated health, history of COVID-19 disease, refusing vaccination against SARS-CoV-2 infection, greater fear of COVID-19 pandemic, living in regions with higher excess mortality, and preventive behavior during the COVID-19 pandemic)’. We also cited additional sources to justify the choice of predictors. May authors also discuss the reasons for differences between different cities or regions? Do any of these regions have any specific characteristics? We think there could be many reasons for differences between different cities or regions, as we write about in the Discussion: ‘Variation in prevalence between Russia’s regions can be related to a large number of factors such as geographic features, socioeconomic status, rates of morbidity and mortality from SARS-CoV-2 infection, residents’ attitudes toward the COVID-19 pandemic, and trust in local government authorities’. This is a very important and interesting question, which needs to be explored in the following studies, as the procedures and methods of diagnosing the COVID-19 disease, the patient routing protocols in case of positive results, and the algorithms for inpatient and outpatient treatment were the same throughout Russia (in accordance with the orders of the Ministry of Health). Once again, we thank you for your help and we hope that we have corrected all the inconsistencies and explained all the shortcomings. With best regards, authors. https://doi.org/10.1371/journal.pone.0282345.r002
12 Dec 2022 Decision Letter - Ahmet Murt, Editor PONE-D-22-18719R1Somatic burden in Russia during the COVID-19 pandemicPLOS ONE Dear Dr. Zolotareva, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== ============================== Please submit your revised manuscript by Jan 26 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Ahmet Murt Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: Dear Authors, Our reviewers stated that the link for your data was not active. Can you please check and assure that your data is available as you stated in your manuscript. Thank you for your contribution to our journal. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: (No Response) Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: (No Response) Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: (No Response) Reviewer #2: No ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: (No Response) Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) Reviewer #2: The suggestions in the previous round were all applied. The authors should not forget to make the data of this study fully available. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0282345.r003
Revision 2
28 Jan 2023 Author Response Dear Reviewers, Thank you for your help in improving our manuscript! We had probably included a peer-review link only. We have now replaced it with a link to our dataset in the OSF repository (https://osf.io/9hw52/) that is publicly available without restrictions. Best regards, the authors. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0282345.r004
14 Feb 2023 Decision Letter - Ahmet Murt, Editor Somatic burden in Russia during the COVID-19 pandemic PONE-D-22-18719R2 Dear Dr. Zolotareva, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Ahmet Murt Academic Editor PLOS ONE Additional Editor Comments (optional): Thank you for your efforts to answer the reviewers' concerns. Reviewers' comments: https://doi.org/10.1371/journal.pone.0282345.r005
Formally Accepted
28 Feb 2023 Acceptance Letter - Ahmet Murt, Editor PONE-D-22-18719R2 Somatic burden in Russia during the COVID-19 pandemic Dear Dr. Zolotareva: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Ahmet Murt Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0282345.r006

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .