Effect of a Symptom Diary on Symptom Frequency and Intensity in Healthy Subjects

Objective. Symptom and pain diaries are often recommended to or used by patients with chronic pain disorders. Our objective was to examine the effect on recall of symptoms after 14 days of daily symptom diary use in healthy subjects.

Method. Subjects were randomly assigned to 1 of 2 groups: the diary group and the control group. Both subject groups completed an initial symptom checklist composed of headache, neck pain, back pain, fatigue, abdominal pain, elbow pain, jaw pain, and numbness/tingling in arms or legs. Both groups indicated their symptom frequency and their perceived average symptom severity in the last 14 days. The diary group was asked then to examine the symptom checklist daily for 14 days while the control group was not. After 2 weeks, both groups then repeated the symptom checklist for recall of symptoms and symptom severity.

Results. A total 35 of 40 initially recruited subjects completed all the questionnaires, 18 in the diary group and 17 in the control group. At the outset, both groups had similar frequencies and intensities of symptoms. After 2 weeks of symptom diary use, diary group subjects had an increased frequency (doubled) of recalled symptoms, and significantly increased intensity of symptoms compared with the control group, which had not changed its mean frequency or intensity of symptoms.

Conclusion. The use of a symptom diary for 2 weeks, even in generally healthy subjects, results in increased recall of daily symptoms and increased perception of symptom severity.