Somatic symptoms in children and adolescents: impairment and associations with psychological and parental factors
- Autores: Teodora Cosmina Zolog
- Directores de la Tesis: Maria del Claustre Jané i Ballabriga (dir. tes.), Albert Bonillo Martín (codir. tes.)
- Lectura: En la Universitat Autònoma de Barcelona ( España ) en 2011
- Idioma: español
- Tribunal Calificador de la Tesis: Susana Subirà (presid.), Sergi Valero i Ventura (secret.), Joaquima Planella Morató (voc.)
- Materias:
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- Resumen
Objectives: -To document the two-week prevalence of specific somatic complaints; -To examine the associations between somatization, specific somatic complaints and symptoms of general anxiety, depression and types of anxiety symptoms (separation, generalized and social phobia symptoms); -To investigate if there is a functional impairment in frequently complaining children ( who reported four or more symptoms in the last two weeks) compared with children with fewer somatic complaints ( three or less in the last two weeks); -To examine the associations between dimensions of negative affectivity and somatic complaints and behaviors associated to somatic complaints (health care utilization; missed school due to somatic complaints); -To investigate the relations between parental mental distress (anxiety, depression somatization and social dysfunction) and somatic complaints in their children; Method: Two types of samples were used: 1) A community sample of preadolescents and early adolescents. This is a cross-sectional study where a cluster sampling procedure was used, with 1,514 randomly selected 4th to 6th grade pupils from Catalonia (Spain). Information about anxiety, depression and somatic symptoms was collected by means of self-reports. 2) A clinic-based sample where 122 children from the Infant and Adolescent Mental Health Centers (Catalonia), ages 3 to 10 years and their parents participated in this cross-sectional study. Parental questionnaires were used to inquire about somatic symptoms in the child, preschool and school absences, pediatric help-seeking, parental mental distress (General Health Questionnaire) and dimensions of negative affectivity in children (The Children's Behavior Questionnaire; The Temperament in Middle Childhood Questionnaire).
Results: In the community sample of preadolescents and early adolescents, the most prevalent somatic symptoms were abdominal pain (11.2%) and headaches (10.1%). Through logistic regression analysis, positive significant associations were found between general anxiety, depression symptoms, separation and social phobia symptoms on one hand, and somatization on the other hand; and between separation anxiety symptoms and headaches, abdominal pain, leg pains, tiredness, and dizziness. Frequently complaining children have more impairment in their activity at home, school and in relationships with peers.
Through lineal and logistic regression analysis, in the second sample of children ages 3 to 10 years, positive significant associations were obtained between anger/frustration and dizziness; and between discomfort and pediatric help-seeking. Negative significant associations were obtained between self-soothing and dizziness and between fearfulness and searching for medical help. Findings revealed positive significant associations between social dysfunction in parents on one hand and frequency of somatic complaints, abdominal pain, headaches and legs pain in children on the other. Also, positive significant associations were established between general mental distress in parents on one hand and abdominal pain in children and frequency of medical consultation on the other.
Conclusions: Factors associated to somatic symptoms in children and adolescents enable to identify the risk factors implicated in development of somatization in children. Also, increased functional impairment in children with somatic complaints highlights the importance of developing useful interventions. Cognitive-behavioral interventions as well as family therapy are discussed.
