This study contradicts the generally accepted idea that psychosocial stressinfluences stress responsive systems.Summary213We conclude that dysfunction of stress responsive systems is not a necessaryfactor for somatization in general. However, lowered cardiac vagal activity,hypocortisolism, and possibly low-grade immune activation, may be relevant inthe etiology in subgroups of patients with FSD. Such subgroups need to be betteridentified in order to target and improve treatment strategies based onnormalization of function of the stress responsive systems. (from the summary)