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Fernandez A, Askenazy F, Zeghari R, Auby P, Robert P, Thümmler S, Gindt M. Somatic and Posttraumatic Stress Symptoms in Children and Adolescents in France. JAMA Netw Open 2024; 7:e247193. [PMID: 38635269 DOI: 10.1001/jamanetworkopen.2024.7193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Importance Somatic symptoms are a major concern among the pediatric population because of frequency and burden. The association between adverse childhood experiences and somatic symptoms in adults is well established but less is known concerning somatic symptoms in young people. Objective To explore the frequency and intensity of somatic symptoms in children and adolescents exposed to traumatic events. Design, Setting, and Participants This cross-sectional study was conducted from January 1 to December 31, 2021, at the Nice Pediatric Psychotrauma Referral Center in Nice, France. Participants included pediatric outpatients, aged 7 to 17 years, who were referred to the center. Statistical analysis was performed in January 2022. Exposure All participants experienced at least 1 traumatic event during life. Main Outcome and Measure Somatic and posttraumatic stress symptoms were assessed using the Patient Health Questionnaire-13 (PHQ-13) and Child PTSD Checklist (CPC). Posttraumatic stress disorder (PTSD) and non-PTSD groups were defined based on CPC symptoms severity score. In the hypothesized association between somatic symptoms and posttraumatic stress symptoms (PTSS), PTSD and non-PTSD groups were compared, correlations between PTSS and severity of CPC were analyzed, and a regression model was performed. Results There were 363 participants included (mean [SD] age, 13.58 [0.25] years; 174 [47.9%] female, 189 [52.1%] male). Compared with the non-PTSD group, the PTSD group presented with a higher mean (SD) number of somatic symptoms (7.0 [2.5] vs 4.0 [2.5] symptoms; t360 = 11.7; P < .001), and higher mean (SD) intensity (10.4 [4.6] vs 4.8 [3.7] points; t360 = 12.6; P < .001). Most of the explored somatic symptoms positively correlated with the intensity of PTSS and their functional alterations (eg, PTSS intensity correlated with stomach pain symptoms [r = .30; P < .001]; and with headaches symptoms [r = .44; P < .001]). In the regression model, the combination of migraines, palpitation, nausea, tiredness, and sleep disorders explained 6.5% of the variance in the PTSD group. (F1,341 = 22.651; P < .001). Conclusions and Relevance In this cross-sectional study, somatic symptoms were positively correlated with PTSS both in frequency and intensity among youths. These results suggest that the systematic screening for somatic symptoms in youths with traumatic exposure should be a routine evaluation procedure.
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Affiliation(s)
- Arnaud Fernandez
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
- Centre Régional du Psychotraumatisme PACA, Nice, France
| | - Florence Askenazy
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
- Centre Régional du Psychotraumatisme PACA, Nice, France
| | - Radia Zeghari
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Philippe Auby
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Philippe Robert
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Susanne Thümmler
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Morgane Gindt
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
- Centre Régional du Psychotraumatisme PACA, Nice, France
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Bekaroğlu E, Yılmaz T. How Perceptions of Parents' Parenting Behaviors Pave the Way to Somatic Symptoms: The Mediating Role of Emotion Regulation Among Adults. Psychol Rep 2023:332941231191722. [PMID: 37485851 DOI: 10.1177/00332941231191722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
The purpose of this study was to investigate adult participants' reflections on their parents' parenting behaviors during childhood (parental overprotection and parental rejection), and their current emotion-regulation strategies and somatic symptoms. The study consisted of 627 participants and Somatization subscale of the Symptom Checklist-90-Revised, Difficulties in Emotion Regulation Scale and Short EMBU Children Form were given to the participants. Four different multiple mediation analyses were conducted to test mediator roles of emotion regulation difficulties between perceptions of the parenting behaviors (parental overprotection and rejection) and somatic symptoms among adults. Participants' lack of goals and lack of strategies while dealing with negative emotions mediated the relationship between mother/father rejection and somatic symptoms. However, only participants' lack of strategies while dealing with negative emotions mediated the relationship between mother/father overprotection and somatic symptoms. As a clinical implication, problem-focused coping strategies may assist adults with somatic symptoms. Also, mental health practitioners may focus on perceptions of overprotective and rejecting parental behaviors while formulizing somatic symptoms of the adult patients. Findings, strengths and limitations of this study were discussed in the light of the literature.
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Affiliation(s)
- Ece Bekaroğlu
- Department of Psychology, Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Tuğba Yılmaz
- Department of Psychology, Marmara University, İstanbul, Turkey
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Common infectious morbidity and white blood cell count in middle childhood predict behavior problems in adolescence. Dev Psychopathol 2023; 35:301-313. [PMID: 34420539 DOI: 10.1017/s0954579421000675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We examined the associations of middle childhood infectious morbidity and inflammatory biomarkers with adolescent internalizing and externalizing behavior problems. We recruited 1018 Colombian schoolchildren aged 5-12 years into a cohort. We quantified white blood cell (WBC) counts and C-reactive protein at enrollment and prospectively recorded incidence of gastrointestinal, respiratory, and fever-associated morbidity during the first follow-up year. After a median 6 years, we assessed adolescent internalizing and externalizing behavior problems using child behavior checklist (CBCL) and youth self-report (YSR) questionnaires. Behavior problem scores were compared over biomarker and morbidity categories using mean differences and 95% confidence intervals (CI) from multivariable linear regression. Compared with children without symptoms, CBCL internalizing problem scores were an adjusted 2.5 (95% CI: 0.1, 4.9; p = .04) and 3.1 (95% CI: 1.1, 5.2; p = .003) units higher among children with moderate diarrhea with vomiting and high cough with fever rates, respectively. High cough with fever and high fever rates were associated with increased CBCL somatic complaints and anxious/depressed scores, respectively. WBC >10,000/mm3 was associated with both internalizing problem and YSR withdrawn/depressed scores. There were no associations with externalizing behavior problems. Whether or not decreasing the burden of common infections results in improved neurobehavioral outcomes warrants further investigation.
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Among the swedish generation of adolescents who experience an increased trend of psychosomatic symptoms. Do they develop depression and/or anxiety disorders as they grow older? BMC Psychiatry 2022; 22:779. [PMID: 36503425 PMCID: PMC9743552 DOI: 10.1186/s12888-022-04432-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms - somatic, psychological and musculoskeletal - have different impacts on adult mental health. METHODS One thousand five hundred forty-five Swedish adolescents - aged 13 (49%) and 15 (51%) - completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run. RESULTS Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships. CONCLUSIONS The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.
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Sánchez-Ferrer F, Cervantes-García E, Gavilán-Martín C, Quesada JA, Cortes-Castell E, Nso-Roca AP. Emotional impact on children during home confinement in Spain. Front Public Health 2022; 10:969922. [PMID: 36311580 PMCID: PMC9614421 DOI: 10.3389/fpubh.2022.969922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/26/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction The COVID-19 pandemic has brought about important changes. On March 14, 2020, a strict home confinement was decreed in Spain. Children did not attend school and were not allowed to leave their homes. The aim of this study was to determine the emotional state of these children, as well as associated factors. Material and methods A cross-sectional descriptive study was conducted using an online questionnaire sent by cell phone. This survey includes sociodemographic items and questions concerning the emotional impact of the lockdown. With the questions on emotions, two categories of emotional state were established with the variables fear, irritability, sadness and somatization: those who were less or more emotionally affected. A multivariate logistic model was used to estimate the associations between the variables. Results A total of 3,890 responses were obtained. The mean age of the children was 6.78 years (range 0 to 16). A score indicating poor emotional state was reported by 40.12%. The multivariate logistic model for poor emotional state was directly associated with having less appetite, sleep disturbances, and with parents' beliefs that their child will have difficulties returning to normal life after lockdown. A better emotional state was associated with being an only child, access to outdoor spaces at home, having pets, and parents informing their children about the pandemic using creative explanations. Conclusions During strict home confinement, a considerable emotional impact was observed in children as described by their parents. Specific elements were associated with a better or poorer emotional state.
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Affiliation(s)
- Francisco Sánchez-Ferrer
- San Juan de Alicante University Hospital, Sant Joan d'Alacant, Spain,Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University Medical School, Miguel Hernández University of Elche, Sant Joan d'Alacant, Spain
| | | | - César Gavilán-Martín
- San Juan de Alicante University Hospital, Sant Joan d'Alacant, Spain,Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University Medical School, Miguel Hernández University of Elche, Sant Joan d'Alacant, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Miguel Hernández University Medical School, Miguel Hernández University of Elche, Sant Joan d'Alacant, Spain,*Correspondence: José Antonio Quesada
| | - Ernesto Cortes-Castell
- Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University Medical School, Miguel Hernández University of Elche, Sant Joan d'Alacant, Spain
| | - Ana Pilar Nso-Roca
- San Juan de Alicante University Hospital, Sant Joan d'Alacant, Spain,Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University Medical School, Miguel Hernández University of Elche, Sant Joan d'Alacant, Spain
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Salmon M, Sibeoni J, Harf A, Moro MR, Ludot-Grégoire M. Systematic review on somatization in a transcultural context among teenagers and young adults: Focus on the nosography blur. Front Psychiatry 2022; 13:897002. [PMID: 35958663 PMCID: PMC9358691 DOI: 10.3389/fpsyt.2022.897002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
Aims Somatic complaints are a frequent cause for consultation in primary care. In a transcultural context, somatic complaints are typically associated with psychological distress. A recent review about somatic symptom disorders in adolescence showed some nosographic heterogeneity and outlined various etiological hypotheses (traumatic, environmental, or neurologic), separate from the cross-cultural considerations. Migrants' children encounter specific problems involving cultural mixing-issues of filiation (familial transmission) and affiliation (belonging to a group). This paper aims to provide a systematic review of somatization in transcultural contexts among teenagers and young adults, aged 13 to 24, over the past decade. Methods This review adheres to the quality criteria set forth by the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two authors queried three English databases (Medline, PsycInfo, WebOfScience) about somatization in transcultural contexts (migrant or non-Western population) among teenagers (13-18), young adults (19-24), or both. The methodological process comprised articles selection, data extraction, and then the analysis of emerging themes. Setting selection criteria to limit the transcultural field was difficult. Results The study analyzed 68 articles. We present a descriptive analysis of the results, centered on three main themes. First, the literature highlights a nosographic muddle reflected in the combination of anxious and depressive symptoms together with the highly variable symptomatology. Second, discrimination issues were prevalent among the migrant population. Lastly, the literature review points out possibilities for improving a care pathway and reducing the diagnostic delay induced by migrants' hesitancy about Western care and the recurrent use of inappropriate diagnostic criteria. Conclusion This review discusses the links between the nosographic muddle described here and the diagnostic delays these patients experience and raises concerns about rigid diagnostic compartmentalization. The work of the psychiatrist Frantz Fanon is here useful to understand externalized symptoms resulting from physical and psychological confinement. Discrimination issues raise questions about the cultural counter-transference health professionals experience in dealing with young migrants. Defining healthcare professionals' representations about somatic complaints in a transcultural context might be a fruitful path to explore in future research. Protocol PROSPERO registration number CRD42021294132. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021294132.
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Affiliation(s)
- Mathilde Salmon
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Jordan Sibeoni
- Service Universitaire de Psychiatrie de l'Adolescent, Centre Hospitalier d'Argenteuil, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
| | - Aurélie Harf
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Marie Rose Moro
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
| | - Maude Ludot-Grégoire
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
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Helin N, Kolho K, Merras‐Salmio L. Parentally reported early childhood upper gastrointestinal symptoms alleviate at school age. Acta Paediatr 2022; 111:174-182. [PMID: 34516678 DOI: 10.1111/apa.16106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/20/2021] [Accepted: 09/10/2021] [Indexed: 11/28/2022]
Abstract
AIM This study estimated follow-up outcomes for children presenting with troublesome upper gastrointestinal (GI) symptoms in early childhood. METHODS We identified from our upper endoscopy registry children with undefined GI symptoms having undergone an oesophagogastroduodenoscopy to rule out oesophagitis at a median age of 2.6 years in 2006-2016. We included only those with normal findings. In early 2020, we performed a National Patient Data Repository and Prescription Service review to note patients' current GI symptoms, medications and medical consultations. We also employed a study-specific questionnaire with a validated quality-of-life measure (the PedsQL). RESULTS After a median of 7.9 years of follow-up, the children (n = 199) had a median age of 10.6 years. Medical consultations related to upper GI symptoms were rare. However, parents reported recurrent GI symptoms in 24% of the children, and 41% followed a specific diet. Regular anti-acid medication was in use in 3.5% of the cohort, more often when with a predisposing condition for reflux disease. The current quality of life was good. CONCLUSION Although some upper GI symptoms may persist after early childhood, patients without diseases predisposing to reflux disease have a good quality of life without GI-related morbidity in school age.
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Affiliation(s)
- Noora Helin
- Children's Hospital Paediatric Research Centre University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Kaija‐Leena Kolho
- Children's Hospital Paediatric Research Centre University of Helsinki and Helsinki University Hospital Helsinki Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Laura Merras‐Salmio
- Children's Hospital Paediatric Research Centre University of Helsinki and Helsinki University Hospital Helsinki Finland
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Van Dyk TR, Krietsch KN, King CD, Byars KC. Prevalence of somatic and pain complaints and associations with sleep disturbance in adolescents with insomnia presenting to a behavioral sleep medicine clinic. J Clin Sleep Med 2022; 18:151-160. [PMID: 34251332 PMCID: PMC8807915 DOI: 10.5664/jcsm.9522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVES Sleep problems are highly comorbid with pediatric pain, yet there is a dearth of research on how pain and somatic complaints impact adolescent insomnia presentation and response to cognitive-behavioral therapy for insomnia (CBT-I). This study aims to (1) determine the prevalence of parent-reported somatic/pain complaints in adolescents with insomnia presenting to a behavioral sleep clinic, (2) assess the impact of somatic/pain complaints on initial sleep presentation, and (3) assess the impact of baseline somatic/pain complaints on response to CBT-I. METHODS Participants included adolescents (n = 375) presenting to a behavioral sleep medicine center with a primary diagnosis of insomnia. As a part of clinical care, pre-evaluation measures were completed including the Pediatric Insomnia Severity Index, Adolescent Sleep Hygiene Scale, Adolescent Sleep Wake Scale, and Child Behavior Checklist. The Somatic Syndrome Scale of the Child Behavior Checklist measured somatic complaints and teens were categorized as endorsing pain if reported to experience aches/pains, headaches, or stomachaches. Adolescents completed the Pediatric Insomnia Severity Index at end of treatment. RESULTS Most adolescents had parent-reported somatic (61.1%) and/or pain complaints: headaches (66.6%), stomachaches (48.5%), and aches/pains (45.1%). Greater somatic and pain complaints predicted a worse sleep presentation at intake (all P < .05). After controlling for insomnia severity at intake, neither end-of-treatment insomnia severity nor treatment status were predicted by somatic and pain complaints at intake. CONCLUSIONS Results suggest that parent-reported somatic/pain complaints are prevalent in > 50% of adolescents seeking behavioral insomnia treatment. Although complaints are associated with more severe insomnia at intake, they do not appear to interfere with treatment response. CITATION Van Dyk TR, Krietsch KN, King CD, Byars KC. Prevalence of somatic and pain complaints and associations with sleep disturbance in adolescents with insomnia presenting to a behavioral sleep medicine clinic. J Clin Sleep Med. 2022;18(1):151-160.
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Affiliation(s)
- Tori R. Van Dyk
- Department of Psychology, Loma Linda University, Loma Linda, California,Address correspondence to: Tori R. Van Dyk, PhD, Department of Psychology, Loma Linda University, 11130 Anderson St, Loma Linda, CA 92350;
| | - Kendra N. Krietsch
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Christopher D. King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Center for Understanding Pediatric Pain (CUPP), Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kelly C. Byars
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio,Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Wang A, Duan L, Huang H, Ma J, Zhang Y, Ma Q, Guo Y, Li Z, Cheng X, Zhu J, Zhou G, Ba Y. Association between fluoride exposure and behavioural outcomes of school-age children: a pilot study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:232-241. [PMID: 32281876 DOI: 10.1080/09603123.2020.1747601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
To assess the association between fluoride exposure and children's behavioural outcomes, we recruited 325 resident school-age children (7-13 years old) lived in Tongxu County of Henan Province in China. We measured urinary fluoride (UF) concentrations using the ion-selective electrode method. Children's behavioural outcomes were assessed by Conners' Parent Rating Scale-Revised, including conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, anxiety, and ADHD index. It turned out that each 1.0 mg/L increment in UF concentration corresponded with an elevation in the psychosomatic problem score of 4.01 (95% CI: 2.74, 5.28) and a 97% (OR = 1.97, 95% CI: 1.19, 3.27) increase in the prevalence of psychosomatic problems after adjusting for potential influencing factors. The sensitivity analysis results were consistent with those observed in our preliminary analysis. Our study suggests that fluoride exposure is positively related to the behavioural problem in school-age children, psychosomatic problem in particular.
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Affiliation(s)
- Anqi Wang
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Leizhen Duan
- Department of Medical Services, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Hui Huang
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jun Ma
- Department of Endemic Disease, Kaifeng Center for Disease Control and Prevention, Kaifeng, Henan, P. R. China
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Qiang Ma
- Teaching and Research Office, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yao Guo
- Nursing College of Henan University of Chinese Medicine, Zhengzhou, Henan, P. R. China
| | - Zhiyuan Li
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Xuemin Cheng
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jingyuan Zhu
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Guoyu Zhou
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yue Ba
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
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Löffler-Stastka H, Dietrich D, Sauter T, Fittner M, Steinmair D. Simulating the mind and applications – a theory-based chance for understanding psychic transformations in somatic symptom disorders. World J Meta-Anal 2021; 9:474-487. [DOI: 10.13105/wjma.v9.i6.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/15/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023] Open
Abstract
With the new category of somatic symptom disorder/bodily distress disorder in ICD-11, research into pathogenetic and therapeutic pathways is stimulated. By turning away from the definition of somatoform disorders as “the lack of something physical explaining everything”, this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom. Modelling and simulation have a long history in science to gain insight also into complex phenomena. Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research. Calculation models have to fit to the complexity of this disorder category. In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer, fine grained calculation model is elaborated. Starting from a clinical case history, within iterative discussion, by acknowledging the demand for interdisciplinary synergy and cooperation in science, psychoanalytic theory served as the basis for computer-scientific information technique. A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research. How psychic transformations can be understood properly in order to provide meaningful treatments, the respective training, and to conduct appropriate process- and outcome-research is established in simulating the mind and applications.
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Affiliation(s)
| | | | - Thilo Sauter
- Institute of Computer Technology, TU Wien, Vienna 1040, Austria
- Center for Integrated Sensor Systems, Danube University Krems, Wiener Neustadt 2700, Austria
| | - Martin Fittner
- Institute of Computer Technology, TU Wien, Vienna 1040, Austria
| | - Dagmar Steinmair
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna 1090, Austria
- University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten 3100, Austria
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11
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Pediatric somatization in the emergency department: assessing missed opportunities for early management. CAN J EMERG MED 2021; 22:331-337. [PMID: 32037998 DOI: 10.1017/cem.2019.477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Somatization is a common phenomenon that can severely complicate youths' functioning and health. The burden of somatization on pediatric acute care settings is currently unclear; better understanding it may address challenges clinicians experience in effectively caring for somatizing patients. In this study, we estimate the prevalence of somatization in a pediatric emergency department (ED). METHODS We conducted a retrospective cross-sectional study of visits for non-critical, non-mental health-related concerns (n = 150) to a quaternary-level pediatric ED between July 2016 and August 2017. Demographic and clinical visit details were collected through chart review and used by two reviewing clinicians to classify whether each visit had a "probable," "unclear" (possible), or "unlikely" somatizing component. RESULTS Approximately 3.33% (n = 5) of youth displayed probable somatization, and an additional 13.33% (n = 20) possibly experienced a somatizing component but require additional psychosocial and visit documentation to be certain. Longer symptom duration and multiple negative diagnostic tests were associated with a higher likelihood of either probable or possible somatization. CONCLUSIONS A considerable proportion of non-mental health-related visits may involve a somatizing component, indicating the burden of mental health concerns on the ED may be underestimated. A higher index of suspicion for the possibility of somatization may support clinicians in managing somatizing patients.
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Casanovas M, Kramer T, Clarke V, Goddard A, M Elena G, Khadr S. Somatic symptoms following sexual assault in adolescents: a prospective longitudinal study. PSYCHOL HEALTH MED 2021; 27:546-558. [PMID: 33573390 DOI: 10.1080/13548506.2021.1874437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Adults and young people with somatoform disorders and somatic symptoms retrospectively report high rates of sexual abuse. We aimed to assess somatic symptoms in young people in the aftermath of a sexual assault and to document links with assault characteristics, with psychopathology and with related functional impairment. This was a prospective cohort study of adolescents seen in specialized clinics in London in the first 6 weeks following a sexual assault and at 4-5 months follow-up. We enquired about somatic symptoms (headaches, abdominal pain and sickness) pre and post assault, and we assessed psychiatric disorders and functional impairment at follow-up using validated scales. Information was obtained on 94 females (mean age 15.6, SD 1.3). There was a statistically significant increase in the number of adolescents reporting somatic symptoms at 4-5-month follow-up (65/94, 69%) (p = 0.035), compared with estimated pre-assault rates (52/94, 55%) and a significant increase in somatic symptoms at follow-up among the victims of violent sexual abuse (p < .001). Subjects with somatic symptoms at follow-up had significant higher rates of psychiatric disorders - especially generalised anxiety disorder, panic disorder and major depressive disorders - as well as lower psychosocial functioning (p < 0.01), than those without somatic symptoms.
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Affiliation(s)
- Marta Casanovas
- Department of Child and Adolescent Psychiatry, Imperial College London, London, UK
| | - Tami Kramer
- Department of Child and Adolescent Psychiatry, Imperial College London, London, UK
| | - Venetia Clarke
- The Havens. King's College Hospital NHS Foundation Trust, London, UK
| | - Andrea Goddard
- The Havens. King's College Hospital NHS Foundation Trust, London, UK.,Department of Paediatrics. Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK
| | - Garralda M Elena
- Department of Child and Adolescent Psychiatry, Imperial College London, London, UK
| | - Sophie Khadr
- The Havens. King's College Hospital NHS Foundation Trust, London, UK.,Institute of Child Health(ICH), Population, Policy and Practice. University College London (UCL), London, UK
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13
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Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228479. [PMID: 33207689 PMCID: PMC7698263 DOI: 10.3390/ijerph17228479] [Citation(s) in RCA: 281] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 02/07/2023]
Abstract
The psychological impact of the COVID-19 pandemic has been widely discussed during the past few months, with scholars expressing concern about its potential debilitating consequences on youth mental health. Hence, this research aimed to provide a systematic review of the evidence on the COVID-19 pandemic’s impact on youth mental health. We conducted a mixed methods integrated review to identify any empirical study that focused on young people ≤ 18 years old. Eight databases were systematically searched to identify studies of any type of research design. The selection procedure followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD4202019375). Twelve studies deemed eligible for data extraction (n = 12,262). The findings show that COVID-19 has an impact on youth mental health and is particularly associated with depression and anxiety in adolescent cohorts. The quality appraisal indicated that all studies were of low or moderate methodological quality. The COVID-19 pandemic is affecting young people’s lives, and thus generating robust research evidence to inform policy decisions is essential. Hence, the methodological quality of future research should be drastically improved.
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14
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Boerner KE, Green K, Chapman A, Stanford E, Newlove T, Edwards K, Dhariwal A. Making Sense of "Somatization": A Systematic Review of its Relationship to Pediatric Pain. J Pediatr Psychol 2020; 45:156-169. [PMID: 32053181 DOI: 10.1093/jpepsy/jsz102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 12/04/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Pain and other physical symptoms commonly co-occur in childhood. There is debate about the relevance of somatization in understanding pain. The present review critically appraised and synthesized the extant literature on the relationship between pediatric pain and somatization. METHODS A systematic review (PROSPERO registration #95956) was conducted in Medline, PsycINFO, EMBASE, and CINAHL using search terms related to pain and somatization in children and adolescents. A total of 156 articles were eligible for inclusion in the review. For studies that measured somatization using a symptom questionnaire, descriptions of "somatization" were extracted. Data regarding the relationship between pain and somatization were extracted for studies measuring somatization using a diagnostic category (e.g., Somatic Symptom and Related Disorders [SSRDs]). RESULTS While many studies using somatic symptom questionnaires described somatization as having a psychological component, this was not always captured in measurement tools. Pain was reported as a common symptom in patients with an SSRD diagnosis, though rates varied depending on the specific diagnosis and pain location. Rates of SSRD diagnoses among pain patients were less frequent than rates of pain amongst SSRD patients. CONCLUSIONS SSRDs and pain commonly co-occur, though rates differ depending on diagnosis and pain location. Understanding the relationship between pain and somatization is complicated by the discrepancy between how somatization is defined and measured in questionnaire studies. A comprehensive and measurable definition of somatization is needed so researchers can better identify the shared and unique contributions of pain and somatization in pediatric populations.
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Affiliation(s)
- Katelynn E Boerner
- Department of Psychiatry, University of British Columbia.,Department of Psychiatry, BC Children's Hospital
| | - Katherine Green
- Department of Psychiatry, BC Children's Hospital.,Department of Medicine, University of British Columbia
| | - Andrea Chapman
- Department of Psychiatry, University of British Columbia.,Department of Psychiatry, BC Children's Hospital
| | | | | | | | - Amrit Dhariwal
- Department of Psychiatry, University of British Columbia.,Department of Psychiatry, BC Children's Hospital
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15
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Herskovic V, Matamala M. Somatización, ansiedad y depresión en niños y adolescentes. REVISTA MÉDICA CLÍNICA LAS CONDES 2020. [DOI: 10.1016/j.rmclc.2020.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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16
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Hulgaard DR, Rask CU, Risor MB, Dehlholm G. Illness perceptions of youths with functional disorders and their parents: An interpretative phenomenological analysis study. Clin Child Psychol Psychiatry 2020; 25:45-61. [PMID: 31079473 DOI: 10.1177/1359104519846194] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Functional disorders, defined as disorders with no clear medical explanation, are common and impose a significant burden on youths, their families, healthcare services and society as a whole. Currently, the literature describes resistance among patients and their families towards psychological symptom explanations and treatments. More knowledge about the thoughts and understandings of youths with functional disorders and their parents is needed. The aim of this study was to explore the illness perceptions of youths with severe functional disorders and their parents. METHODS A qualitative interview study using interpretative phenomenological analyses. The study included 11 youths aged 11-15 years with functional disorders and their parents, where interviews were performed at the point of referral from a somatic to a psychiatric treatment setting. RESULTS Analyses identified three main themes. Themes 1(Ascribing identity to the disorder) and 2 (Monocausal explanations) explore key elements of the participants' illness perceptions, and theme 3 (Mutable illness perceptions) explores how illness perceptions are influenced by experiences from healthcare encounters. CONCLUSIONS The label 'functional disorder' was poorly integrated in the illness perceptions of the youths and their parents. Participants used a monocausal and typically physical explanation rather than a multicausal biopsychosocial explanation for their symptoms.
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Affiliation(s)
- Ditte Roth Hulgaard
- Child and Adolescent Psychiatry, Department of Clinical Research, University of Southern Denmark, Denmark
| | - Charlotte Ulrikka Rask
- Research Unit, Centre for Child and Adolescent Psychiatry, Central Denmark Region, Aarhus University Hospital, Denmark
| | - Mette Bech Risor
- General Practice Research Unit, Department of Community Medicine, UiT, The Arctic University of Norway, Norway
| | - Gitte Dehlholm
- Child and Adolescent Psychiatry, Department of Clinical Research, University of Southern Denmark, Denmark
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17
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Pain-Related Anxiety Among Latinx College Students: Relations to Body Vigilance, Worry, Anxious Arousal, and General Depression. J Racial Ethn Health Disparities 2019; 7:498-507. [PMID: 31845285 DOI: 10.1007/s40615-019-00678-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/18/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
Abstract
Latinx young adults in college (ages 18-25 years) are at an elevated risk for somatic and mental health disparities. Although the experience of pain is among the most common health complaints among Latinx young adults, there is no scientific information about how cognitive-based responses to pain relate to somatic vigilance and mental health among this group. The current study therefore investigated the explanatory role of pain-related anxiety (worry about negative consequences of pain) in terms of body vigilance, worry, anxious arousal, and general depression among Latinx young adults. Participants were Latinx college students (Mage = 21 years; SD = 2.02; 83% female) at a large, southwestern university. Results indicated that greater levels of pain-related anxiety were associated with significantly greater bodily vigilance, worry, anxious arousal, and general depression after adjusting for age, gender, physical functioning, subjective social status, and pain intensity. The current investigation suggests that Latinx young adults who experience elevated levels of pain-related anxiety may be at greater risk for somatic hypervigilance and negative affect symptoms. Therefore, reducing pain-related anxiety among Latinx young adults may be an important therapeutic strategy in efforts to reduce somatic and mental health disparities among this group.
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18
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Zvolensky MJ, Kauffman BY, Bogiaizian D, Viana AG, Bakhshaie J, Rogers AH, Peraza N. Worry Among Latinx Young Adults: Relations to Pain Experience, Pain-Related Anxiety, and Perceived Health. J Racial Ethn Health Disparities 2019; 6:981-989. [PMID: 31102101 DOI: 10.1007/s40615-019-00599-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/03/2019] [Accepted: 05/06/2019] [Indexed: 01/30/2023]
Abstract
Latinx are one of the largest and most rapidly growing segments of the United States (U.S.) population that is significantly impacted by health disparities, including somatic health problems. Young Latinx adults (ages 18-25 years) are at a greater risk for being affected by such health inequalities and there is a need to understand individual-based differences that may contribute to and maintain somatic symptoms, including pain experience, pain beliefs, and perceptions of health. Thus, the current study investigated the explanatory role of worry in association between pain intensity, pain disability, pain-related anxiety, and perceived health among Latinx college students. Participants included 401 (Mage = 21 years; SD = 2.02; 83% female) Latinx students at a large, southwestern university. Results indicated that greater levels of worry were related to increased levels of pain intensity, pain disability, pain-related anxiety, and lower levels of perceived health. These findings were evident above and beyond variance accounted for by gender, age, physical functioning, and subjective social status. Overall, the results from the present investigation suggest that there is greater risk for more severe pain experiences, maladaptive beliefs regarding pain, and worse perceptions of health status among Latinx young adults who experience elevated levels of worry.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA.
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Brooke Y Kauffman
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Daniel Bogiaizian
- Psychotherapeutic Area of Asociación Ayuda, Anxiety Disorders Clinic, Buenos Aires, Argentina
| | - Andres G Viana
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Jafar Bakhshaie
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Andrew H Rogers
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Natalia Peraza
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
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19
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Tingstedt O, Lindblad F, Koposov R, Blatný M, Hrdlicka M, Stickley A, Ruchkin V. Somatic symptoms and internalizing problems in urban youth: a cross-cultural comparison of Czech and Russian adolescents. Eur J Public Health 2019; 28:480-484. [PMID: 29373646 DOI: 10.1093/eurpub/cky001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Although the association between somatic complaints and internalizing problems (anxiety, somatic anxiety and depression) is well established, it remains unclear whether the pattern of this relationship differs by gender and in different cultures. The aim of this study was to examine cross-cultural and gender-specific differences in the association between somatic complaints and internalizing problems in youth from the Czech Republic and Russia. Methods The Social and Health Assessment, a self-report survey, was completed by representative community samples of adolescents, age 12-17 years, from the Czech Republic (N = 4770) and Russia (N = 2728). Results A strong association was observed between somatic complaints and internalizing psychopathology. Although the levels of internalizing problems differed by country and gender, they increased together with and largely in a similar way to somatic complaints for boys and girls in both countries. Conclusion The association between somatic symptoms and internalizing problems seems to be similar for boys and girls across cultures.
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Affiliation(s)
- Olga Tingstedt
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Frank Lindblad
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marek Blatný
- Institute of Psychology, Academy of Sciences of the Czech Republic, Brno, Czech Republic
| | - Michal Hrdlicka
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
| | - Andrew Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Child Study Centre, Yale University Medical School, New Haven, CT, USA.,Säter Forensic Psychiatric Clinic, Säter, Sweden
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20
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Stone AL, Walker LS, Heathcote LC, Hernandez JM, Basch MC, Wilson AC, Simons LE. Somatic Symptoms in Pediatric Patients With Chronic Pain: Proposed Clinical Reference Points for the Children's Somatic Symptoms Inventory (Formerly the Children's Somatization Inventory). THE JOURNAL OF PAIN 2019; 20:932-940. [PMID: 30771592 DOI: 10.1016/j.jpain.2019.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/09/2019] [Accepted: 02/08/2019] [Indexed: 01/30/2023]
Abstract
Among youth with chronic pain, elevated somatic symptoms across multiple body systems have been associated with greater emotional distress and functional disability and could represent poor adaptation to pain. The Children's Somatic Symptoms Inventory (formerly the Children's Somatization Inventory) is commonly used to assess somatic symptoms in children. However, no studies have evaluated the clinical usefulness of the measure in the assessment of pediatric patients with chronic pain. This study evaluated the factor structure and clinical relevance of the 24-item Children's Somatic Symptoms Inventory (CSSI-24) in youth (n = 1,150) with mixed chronic pain complaints presenting to a tertiary pain clinic. The CSSI-24 total scores were equal or superior to factor scores as indicators of patients' clinical characteristics (functional disability, pain catastrophizing, fear of pain, and anxiety and depressive symptoms) and parental catastrophizing and protective responses. Tertile-derived clinical reference points for the CSSI-24 total score (<18, low; 19-31, moderate; ≥ 32, high) significantly differed on measures of clinical characteristics and parent factors. Controlling for age, sex, pain intensity, and primary pain complaint, the high somatic symptoms group exhibited significantly greater health care use compared with the moderate and low groups. The assessment of somatic symptoms in pediatric patients with chronic pain may provide useful information regarding patients' psychosocial risk and tendency to access health services. Perspective: Clinical reference points based on the CSSI-24 total scores meaningfully differentiated youth with chronic pain on measures of emotional distress, functioning, parent catastrophizing and protective responses, and health care use. Assessing somatic symptoms could provide useful information regarding a pediatric patient's psychosocial risk, tendency to access health services, and need for enhanced care coordination.
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Affiliation(s)
- Amanda L Stone
- Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee.
| | - Lynn S Walker
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Lauren C Heathcote
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - J Maya Hernandez
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Molly C Basch
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - Anna C Wilson
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
| | - Laura E Simons
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
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21
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Cardeña E, Schaffler Y. "He Who Has the Spirits Must Work a Lot": A Psycho-Anthropological Account of Spirit Possession in the Dominican Republic. ETHOS (BERKELEY, CALIF.) 2018; 46:457-476. [PMID: 31057191 PMCID: PMC6477824 DOI: 10.1111/etho.12216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 05/28/2018] [Accepted: 06/12/2018] [Indexed: 06/09/2023]
Abstract
In this paper we present a multidisciplinary, developmental analysis of a Dominican Republic Vodou servidor ("Marcos"), from childhood to early adulthood, integrating ethnographic observation, field documentation, and anthropological analysis, with relevant constructs from developmental, personality, and clinical psychology. Marcos transitioned from a child with many problems to a young adult who has learnt how to control and adapt dissociative manifestations into a professional role as a Vodou priest. Most empirical studies on spirit possession (SP) have rarely taken a longitudinal, multidisciplinary approach, which may better account for such a complex phenomenon. Adopting such an approach helps make sense of both the continuity and changes in Marcos, as well as of his community's shifting attitudes towards him. We describe how specific psychological and cultural conditions help explain the change from originally dysfunctional expressions of SP to personally and socially beneficial ones. [anomalous experience, dissociation, gender, spirit possession, Vodou].
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22
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Abstract
OBJECTIVE Somatic complaints, often associated with concurrent and future internalizing symptoms and disorders in adult samples, were examined longitudinally from preschool to school age in a sample of children at an increased familial risk for psychopathology. The behavioral correlates and sex differences of somatic complaints and the persistence of these complaints across early childhood were examined. METHOD A longitudinal sample of 185 mothers completed a laboratory visit when children were preschool aged and an online follow-up when children were school aged. Mothers were assessed for psychopathology, and mothers and secondary caregivers reported on children's somatic complaints, anxiety, and depression at both time points. RESULTS A high rate of child's somatic complaints was noted in this sample, with similar rates in males and females. Regression analyses revealed that somatic complaints at preschool predicted somatic complaints, anxiety, and depression at school age, and sex did not moderate these relationships. Overall, maternal psychopathology predicted somatic complaints, but findings were inconsistent across reporters, time points, and types of maternal psychopathology. Evidence for maternal reporting bias was mixed. CONCLUSION The association between preschool-age somatic complaints and school-age internalizing symptoms suggests the potential utility of early detection and treatment of somatic complaints, particularly for young children at an increased familial risk for developing internalizing disorders. Pediatric primary care is an ideal setting for these early intervention efforts.
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Bohman H, Låftman SB, Cleland N, Lundberg M, Päären A, Jonsson U. Somatic symptoms in adolescence as a predictor of severe mental illness in adulthood: a long-term community-based follow-up study. Child Adolesc Psychiatry Ment Health 2018; 12:42. [PMID: 30123319 PMCID: PMC6090675 DOI: 10.1186/s13034-018-0245-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 07/04/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Somatic symptoms are common and costly for society and correlate with suffering and low functioning. Nevertheless, little is known about the long-term implications of somatic symptoms. The objective of this study was to assess if somatic symptoms in adolescents with depression and in their matched controls predict severe mental illness in adulthood by investigating the use of hospital-based care consequent to different mental disorders. METHODS The entire school population of 16-17-year-olds in the city of Uppsala, Sweden, was screened for depression in 1991-1993 (n = 2300). Adolescents with positive screenings (n = 307) and matched non-depressed controls (n = 302) participated in a semi-structured diagnostic interview for mental disorders. In addition, 21 different self-rated somatic symptoms were assessed. The adolescents with depression and the matched non-depressed controls were engaged in follow-up through the National Patient Register 17-19 years after the baseline study (n = 375). The outcome measures covered hospital-based mental health care for different mental disorders according to ICD-10 criteria between the participants' ages of 18 and 35 years. RESULTS Somatic symptoms were associated with an increased risk of later hospital-based mental health care in general in a dose-response relationship when adjusting for sex, adolescent depression, and adolescent anxiety (1 symptom: OR = 1.63, CI 0.55-4.85; 2-4 symptoms: OR = 2.77, 95% CI 1.04-7.39; ≥ 5 symptoms: OR = 5.75, 95% CI 1.98-16.72). With regards to specific diagnoses, somatic symptoms predicted hospital-based care for mood disorders when adjusting for sex, adolescent depression, and adolescent anxiety (p < 0.05). In adolescents with depression, somatic symptoms predicted later hospital-based mental health care in a dose-response relationship (p < 0.01). In adolescents without depression, reporting at least one somatic symptom predicted later hospital-based mental health care (p < 0.05). CONCLUSIONS Somatic symptoms in adolescence predicted severe adult mental illness as measured by hospital-based care also when controlled for important confounders. The results suggest that adolescents with somatic symptoms need early treatment and extended follow-up to treat these specific symptoms, regardless of co-occurring depression and anxiety.
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Affiliation(s)
- Hannes Bohman
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, 75124 Uppsala, Sweden
- Department of Women’s and Children’s Health, Akademiska University Hospital, 75185 Uppsala, Sweden
- Department of Clinical Science and Education, Södersjukhuset/Karolinska Institutet, 11883 Stockholm, Sweden
| | - Sara B. Låftman
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden
| | - Neil Cleland
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Mathias Lundberg
- Department of Clinical Science and Education, Södersjukhuset/Karolinska Institutet, 11883 Stockholm, Sweden
| | - Aivar Päären
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, 75124 Uppsala, Sweden
| | - Ulf Jonsson
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Box 593, 75124 Uppsala, Sweden
- Department of Women’s & Children’s Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, CAP Research Center, Gävlegatan 22B, Floor 8, 113 30 Stockholm, Sweden
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24
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Randall ET, Smith KR, Kronman CA, Conroy C, Smith AM, Simons LE. Feeling the Pressure to Be Perfect: Effect on Pain-Related Distress and Dysfunction in Youth With Chronic Pain. THE JOURNAL OF PAIN 2017; 19:418-429. [PMID: 29248510 DOI: 10.1016/j.jpain.2017.11.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 11/01/2017] [Accepted: 11/28/2017] [Indexed: 01/18/2023]
Abstract
Despite clinical observation of perfectionistic tendencies among youth with chronic pain and their parents as well as established relationships between perfectionism and functional somatic symptoms in adults and youth, no research in the pediatric pain literature has examined perfectionism. This study explored the role of various types of youth and parent perfectionism on youth and parent pain-related distress and behavior and youth pain-related dysfunction. At admission, 239 parent-child pairs from outpatient and day-treatment rehabilitation settings completed several questionnaires assessing perfectionism, pain-related distress, and pain-related dysfunction. Bivariate correlations indicated that socially prescribed perfectionism in youth and parents was linked to youth pain duration, parent and youth pain-related distress and behavior, and youth somatization. Indirect relations showed that youth socially prescribed perfectionism was the only form of perfectionism directly associated with youth somatization whereas all forms of youth perfectionism were indirectly associated with somatization and functional disability through increases in youth pain-related fear and catastrophizing. Additionally, socially prescribed perfectionism was the only type of parent perfectionism linked to youth pain-related dysfunction (somatization, functional disability) through its association with youth pain-related fear. Findings support clinical observations that parent and youth perfectionism is a psychosocial factor that should be targeted in pediatric chronic pain treatment. PERSPECTIVE Perfectionism in youth with chronic pain and their parents was indirectly linked to youth pain-related dysfunction through its effect on youth pain-related catastrophizing and fear. Findings support clinical observations that parent and youth perfectionism is a psychosocial factor that should be targeted in pediatric chronic pain treatment.
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Affiliation(s)
- Edin T Randall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
| | - Kelly R Smith
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Corey A Kronman
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Caitlin Conroy
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Allison M Smith
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Laura E Simons
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
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25
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Oh W, Volling BL, Gonzalez R, Rosenberg L, Song JH. II. METHODS AND PROCEDURES FOR THE FAMILY TRANSITIONS STUDY. Monogr Soc Res Child Dev 2017; 82:26-45. [PMID: 28766781 PMCID: PMC5596876 DOI: 10.1111/mono.12308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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26
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Beyers-Carlson E, Stevenson MM, Gonzalez R, Oh W, Volling BL, Yu T. IX. DEVELOPMENTAL TRAJECTORIES OF CHILDREN'S SOMATIC COMPLAINTS AFTER THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:118-129. [PMID: 28766780 PMCID: PMC5596877 DOI: 10.1111/mono.12315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Oh W, Song JH, Gonzalez R, Volling BL, Yu T. VIII. DEVELOPMENTAL TRAJECTORIES OF CHILDREN'S WITHDRAWAL AFTER THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:106-117. [PMID: 28766785 PMCID: PMC5596895 DOI: 10.1111/mono.12314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Song JH, Oh W, Gonzalez R, Volling BL, Yu T. V. DEVELOPMENTAL TRAJECTORIES OF CHILDREN'S ATTENTION PROBLEMS AFTER THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:72-81. [PMID: 28766778 PMCID: PMC5596885 DOI: 10.1111/mono.12311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Safyer P, Stevenson MM, Gonzalez R, Volling BL, Oh W, Yu T. X. DEVELOPMENTAL TRAJECTORIES OF CHILDREN'S SLEEP PROBLEMS AFTER THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:130-141. [PMID: 28766776 PMCID: PMC5596883 DOI: 10.1111/mono.12316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kuo PX, Volling BL, Gonzalez R, Oh W, Yu T. VII. DEVELOPMENTAL TRAJECTORIES OF CHILDREN'S EMOTIONAL REACTIVITY AFTER THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:93-105. [PMID: 28766772 PMCID: PMC5596886 DOI: 10.1111/mono.12313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Thomason E, Oh W, Volling BL, Gonzalez R, Yu T. VI. DEVELOPMENTAL TRAJECTORIES OF CHILDREN'S ANXIETY AND DEPRESSION AFTER THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:82-92. [PMID: 28766774 PMCID: PMC5596887 DOI: 10.1111/mono.12312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Volling BL, Gonzalez R, Yu T, Oh W. IV. DEVELOPMENTAL TRAJECTORIES OF CHILDREN'S AGGRESSIVE BEHAVIORS AFTER THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:53-71. [PMID: 28766783 PMCID: PMC5596893 DOI: 10.1111/mono.12310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Volling BL, Oh W, Gonzalez R. III. STABILITY AND CHANGE IN CHILDREN'S EMOTIONAL AND BEHAVIORAL ADJUSTMENT AFTER THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:46-52. [PMID: 28766777 PMCID: PMC5596873 DOI: 10.1111/mono.12309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Volling BL. I. INTRODUCTION: UNDERSTANDING THE TRANSITION TO SIBLINGHOOD FROM A DEVELOPMENTAL PSYCHOPATHOLOGY AND ECOLOGICAL SYSTEMS PERSPECTIVE. Monogr Soc Res Child Dev 2017; 82:7-25. [PMID: 28766787 PMCID: PMC5596879 DOI: 10.1111/mono.12307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The birth of an infant sibling is a common occurrence in the lives of many toddler and preschool children. Early childhood is also a time for the emergence of disruptive behavior problems that may set the stage for later problem behaviors. The current study examined individual differences in young children’s behavioral and emotional adjustment after the birth of a sibling in an effort to uncover developmental trajectories reflecting sudden and persistent change (maladaptation), adjustment and adaptation (resilience), gradual linear increases, and no change (stability and continuity). Growth mixture modeling (GMM) was conducted with a sample of 241 families expecting their second child using a longitudinal research design across the first year after the sibling’s birth (prenatal, 1, 4 8 and 12 months) on seven syndrome scales of the Child Behavior Checklist (CBCL 1.5–5:(Achenbach & Rescorla, 2000 ): aggression, attention problems, anxiety/depression, emotional reactivity, withdrawal, somatic complaints, and sleep problems. For all scales, multiple classes describing different trajectory patterns emerged that reflected predominantly intercept differences; children high on problem behavior after the birth were those high before the birth. There was no evidence of a sudden, persistent maladaptive response indicating children underwent a developmental crisis for any of the problem behaviors examined. Most children were low on all problem behaviors examined and showed little change or actually declined in problem behaviors over time, although some children did experience more pronounced changes in the borderline clinical or clinical range. Only in the case of aggressive behavior was there evidence of an Adjustment and Adaptation Response showing a sudden change (prenatal to 1 month) that subsided by 4 months, suggesting that some young children react to stressful life events but adapt quickly to these changing circumstances. Further, children’s withdrawal revealed a curvilinear, quadratic path, suggesting children both increased and decreased in their withdrawal over time. Guided by a developmental ecological systems framework, we employed data mining procedures to uncover the child, parent, and family variables that best discriminated the different trajectory classes and found that children’s temperament, coparenting, parental self-efficacy, and parent-child attachment relationships were prominent in predicting children’s adjustment after the birth of an infant sibling. Finally, when trajectory classes were used to predict sibling relationship quality at 12 months, children high on aggression, attention problems, and emotional reactivity in the year after the birth engaged in more conflict and less positive involvement with the infant sibling at the end of the first year.
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Volling BL. XI. GENERAL DISCUSSION: CHILDREN'S ADJUSTMENT AND ADAPTATION FOLLOWING THE BIRTH OF A SIBLING. Monogr Soc Res Child Dev 2017; 82:142-158. [PMID: 28766773 PMCID: PMC5596891 DOI: 10.1111/mono.12317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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REFERENCES. Monogr Soc Res Child Dev 2017. [DOI: 10.1111/mono.12318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shah R, Chauhan N. Somatoform Pain Disorder Presenting as "Atypical Facial Pain:" A Rare Presentation in a 13-year-old. Indian J Psychol Med 2017; 39:500-502. [PMID: 28852247 PMCID: PMC5560001 DOI: 10.4103/0253-7176.211740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Children and adolescents often present to physicians and pediatricians with a range of medically unexplained symptoms, most common being headache, abdominal, and bone pains. These symptoms can be a manifestation of underlying depressive, anxiety or somatoform disorders, and sometimes the only symptom. Hence, it is important to recognize and manage these symptoms. Atypical facial pain (AFP) or atypical trigeminal neuralgia that has variably been described to be of psychological origin is considered to be rare in children. We describe the case of a 13-year-old adolescent girl who presented with AFP, who was finally diagnosed to have a somatoform disorder. We discuss the characteristics of AFP in the index case that justify the diagnosis. We also attempt to describe psychosocial factors related to such a presentation.
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Affiliation(s)
- Ruchita Shah
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nidhi Chauhan
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Wasylynko DE. Chiropractic Care of a 10-Year-Old Boy With Nonorganic Gait Disorder: A Case Report. J Chiropr Med 2017; 16:175-179. [PMID: 28559759 DOI: 10.1016/j.jcm.2017.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 02/14/2017] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The purpose of this case report is to describe the multidisciplinary management of a boy with nonorganic gait disorder. CLINICAL FEATURES A 10-year-old boy presented to a chiropractic clinic having had a concussion 1 week prior. He presented with lower limb muscle weakness and ataxia while weight bearing. He was referred immediately to the emergency department, from which he was sent to a neurologist at a children's hospital. The neurologist's diagnosis was nonorganic gait disorder. INTERVENTION/OUTCOME Treatment consisted of physiotherapy, occupational therapy, and a psychiatric assessment. Chiropractic care including manipulative therapy was initiated 6 months after diagnosis. After 1 year, the gait disorder was resolved. CONCLUSION The addition of chiropractic care to conventional treatment may have been supportive in the recovery process for this patient. The condition required 1 year to resolve, with questions remaining as to whether the symptom resolution was a result of treatment or natural history.
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Abstract
Somatic symptom disorder (SSD) is a common disorder encountered in pediatric medicine. It involves the presentation of physical symptoms that are either disproportionate or inconsistent with history, physical examination, laboratory, and other investigative findings. SSDs result in significant impairment with considerable increase in healthcare utilization, school absenteeism, and the potential for unnecessary diagnostic evaluation and treatment intervention. Patients and families often feel dismissed and may worry that a serious condition has been missed. Primary care providers are frequently frustrated due to a lack of a successful approach to patients and families impacted by SSD. The result is often a cycle of disability, frustration and missed opportunities for collaboration towards enhanced patient functionality. This review summarizes the current evidence-based understanding, as well as insights from clinician experience, on the evaluation and management of pediatric SSD.
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Uniyal R, Paliwal VK, Tripathi A. Psychiatric comorbidity in new daily persistent headache: A cross-sectional study. Eur J Pain 2017; 21:1031-1038. [PMID: 28146324 DOI: 10.1002/ejp.1000] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND New daily persistent headache (NDPH) is a type of chronic daily headache. NDPH can have migrainous (NDPH-CM) or tension-type character (NDPH-CTTH). Recently, NDPH patients have shown to have associated anxiety and depression. We compared anxiety, depressive symptoms, somatization and pain catastrophization among NDPH, healthy controls and patients with chronic low-back pain and between NDPH-CM and NDPH-CTTH. METHODS We assessed the study population for depressive symptoms by Patient Health Questionnaire-9, anxiety by Generalized Anxiety Disorder Scale - 7, somatoform disorder using DSM IV (TR) criteria and pain catastrophizing by using Pain Catastrophizing Scale. RESULTS Fifty-five patients each with NDPH (mean age 28.24 ± 12.05 years, 45.5% females) and age/sex matched healthy individuals and patients with chronic low-back pain were enrolled. Among NDPH patients, somatoform disorder was seen in 32.7%, severe anxiety in 65.5%, severe depressive symptoms in 40%, significant pain catastrophization in 85.5%. NDPH patients had significantly higher frequency of all psychiatric co-morbidities as compared to healthy controls and patients with chronic low-back pain. NDPH-CM patients had significantly higher frequency of depression and pain catastrophizing behaviour as compared to NDPH-CTTH. CONCLUSION Anxiety, depressive symptoms, somatization and pain catastrophizing were significantly more prevalent in NDPH when compared to healthy individuals and patients with chronic low back pain. Such effects should be sought for, as they might contribute to refractoriness to treatment. SIGNIFICANCE Anxiety, depressive symptoms, somatization and pain catastrophizing were significantly more prevalent in new daily persistent headache when compared to healthy individuals and patients with chronic low back pain. Such effects should be sought for, as they might contribute to refractoriness to treatment.
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Affiliation(s)
- R Uniyal
- Department of Neurology, King George Medical University, Lucknow, U.P., India
| | - V K Paliwal
- Department of Neurology, SGPGIMS, Lucknow, U.P., India
| | - A Tripathi
- Department of Psychiatry, King George Medical University, Lucknow, U.P., India
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Pain is Associated With Poorer Grades, Reduced Emotional Well-Being, and Attention Problems in Adolescents. Clin J Pain 2017; 33:44-50. [DOI: 10.1097/ajp.0000000000000367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Chun TH, Mace SE, Katz ER. Executive Summary: Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms. Pediatrics 2016; 138:peds.2016-1574. [PMID: 27550983 DOI: 10.1542/peds.2016-1574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/24/2022] Open
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Chun TH, Mace SE, Katz ER. Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms. Pediatrics 2016; 138:peds.2016-1573. [PMID: 27550976 DOI: 10.1542/peds.2016-1573] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Root JM, Zuckerbraun NS, Wang L, Winger D, Brent D, Kontos A, Hickey R. History of Somatization Is Associated with Prolonged Recovery from Concussion. J Pediatr 2016; 174:39-44.e1. [PMID: 27059916 PMCID: PMC4925238 DOI: 10.1016/j.jpeds.2016.03.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 02/22/2016] [Accepted: 03/04/2016] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To determine the association between a history of somatization and prolonged concussion symptoms, including sex differences in recovery. STUDY DESIGN A prospective cohort study of 10- to 18-year-olds with an acute concussion was conducted from July 2014 to April 2015 at a tertiary care pediatric emergency department. One hundred twenty subjects completed the validated Children's Somatization Inventory (CSI) for pre-injury somatization assessment and Postconcussion Symptoms Scale (PCSS) at diagnosis. PCSS was re-assessed by phone at 2 and 4 weeks. CSI was assessed in quartiles with a generalized estimating equation model to determine relationship of CSI to PCSS over time. RESULTS The median age of our study participants was 13.8 years (IQR 11.5, 15.8), 60% male, with separate analyses for each sex. Our model showed a positive interaction between total CSI score, PCSS and time from concussion for females P < .01, and a statistical trend for males, P = .058. Females in the highest quartile of somatization had higher PCSS than the other 3 CSI quartiles at each time point (B -26.7 to -41.1, P values <.015). CONCLUSIONS Patients with higher pre-injury somatization had higher concussion symptom scores over time. Females in the highest somatization quartile had prolonged concussion recovery with persistently high symptom scores at 4 weeks. Somatization may contribute to sex differences in recovery, and assessment at the time of concussion may help guide management and target therapy.
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Affiliation(s)
- Jeremy M Root
- Emergency Medicine and Trauma Services, Children's National Medical Center, Washington, DC.
| | - Noel S. Zuckerbraun
- Division of Pediatric Emergency Medicine, Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - Li Wang
- Office of Clinical Research, Heath Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Dan Winger
- Office of Clinical Research, Heath Sciences, University of Pittsburgh, Pittsburgh, PA
| | - David Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Anthony Kontos
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA
| | - Robert Hickey
- Division of Pediatric Emergency Medicine, Children’s Hospital of Pittsburgh, Pittsburgh, PA
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Murberg TA, Bru E. School-Related Stress and Psychosomatic Symptoms among Norwegian Adolescents. SCHOOL PSYCHOLOGY INTERNATIONAL 2016. [DOI: 10.1177/0143034304046904] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This study examines the relationships between school-related stress, gender and psychosomatic symptoms in a sample of 531 adolescents pupils in years (grades) 8, 9 and 10 (aged 13-16 years) from two compulsory schools in Norway. Results showed that 18.1 percent reported being ‘very much’ affected by at least one of the assessed psychosomatic symptoms. Girls reported significantly more psychosomatic symptoms than did boys. Tests of the dimensionality of the school-related stress that was assessed in the present study showed four main categories: (1) difficulties with peers at school; (2) worries about school achievement; (3) schoolwork pressure and (4) conflicts with parents and/or teachers. Results from multiple regression analyses showed that scores for the different stressors were significantly associated with psychosomatic symptoms. Findings suggest that frequency of psychosomatic symptoms might be related to how well or otherwise pupils adapt to the demands of school and to the interpersonal climate of the school. Gender seems to play a differentiating role here. Girls reported significantly more stress that was related to worries about school achievement, whereas boys reported significantly more stress arising from conflicts with parents and/or teachers. Finally, stress due to difficulties with peers at school was more closely correlated with psychosomatic symptoms among boys than among girls.
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Affiliation(s)
| | - Edvin Bru
- Stavanger University College, Stavanger, Norway
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Cottrell DJ. Fifteen-minute consultation: Medically unexplained symptoms. Arch Dis Child Educ Pract Ed 2016; 101:114-8. [PMID: 26837501 DOI: 10.1136/archdischild-2015-309344] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/02/2016] [Indexed: 01/30/2023]
Abstract
Medically unexplained symptoms are common and not always easy to manage. A wide range of symptoms may be presented and anxiety in the child, family and paediatrician about the possibility of a missed serious organic diagnosis may hamper effective management. Evidence-based approaches to a number of different presenting problems share a number of components. A model for assessment and management based on clinical experience and this evidence base is described.
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Risk factors for comorbid psychopathology in youth with psychogenic nonepileptic seizures. Seizure 2016; 38:32-7. [PMID: 27085102 DOI: 10.1016/j.seizure.2016.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/15/2016] [Accepted: 03/30/2016] [Indexed: 01/30/2023] Open
Abstract
PURPOSE To examine the risk factors for internalizing (anxiety, depression) and posttraumatic stress (PTSD) disorders, somatization, and anxiety sensitivity (AS) in youth with psychogenic non-epileptic seizures (PNES). METHODS 55 probands with PNES and 35 siblings, aged 8-18 years, underwent a psychiatric interview, cognitive and language testing, and completed somatization and AS questionnaires. Parents provided the subjects' medical, psychiatric, family, and adversity history information. RESULTS The risk factors for the probands' internalizing disorders (girls, older age of PNES onset), somatization (older age, epilepsy), and anxiety sensitivity (girls, adversities) differed from their siblings. The risk factors in the siblings, however, were similar to the general pediatric population. Proband depression was unrelated to the study's risk variables while PTSD was significantly associated with female gender and lower Full Scale IQ. CONCLUSIONS Knowledge about the specificity of the risk factors for comorbid psychopathology in youth with PNES might facilitate their early identification and treatment.
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Exposure to bisphenol A and behavior in school-age children. Neurotoxicology 2016; 53:12-19. [DOI: 10.1016/j.neuro.2015.12.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/12/2015] [Accepted: 12/01/2015] [Indexed: 01/30/2023]
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Basch MC, Chow ET, Logan DE, Schechter NL, Simons LE. Perspectives on the clinical significance of functional pain syndromes in children. J Pain Res 2015; 8:675-86. [PMID: 26504406 PMCID: PMC4605245 DOI: 10.2147/jpr.s55586] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Functional pain syndromes (FPS) characterize a subset of individuals who experience pain and related symptoms and disability without clear structural or disease etiology. In the pediatric population, FPS hold high clinical importance due to significant prevalence rates and potential to persist into adulthood. Although extensive research has been executed to disambiguate FPS, the syndromes that fall within its spectrum remain conceptually complex and sometimes ill-defined. This paper provides an overview of available research on the classification and multifaceted etiology of FPS in youth and their effects on interpersonal, psychological, and familial function. Vital aspects of a successful multidisciplinary approach to treating this population are described; however, it is evident that future research requires more longitudinal studies.
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Affiliation(s)
- Molly C Basch
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston University, Boston, MA, USA
- Boston Children’s Hospital, Center for Pain and the Brain, PAIN Research Group, Boston University, Boston, MA, USA
| | - Erika T Chow
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston University, Boston, MA, USA
- Boston University School of Medicine, Boston University, Boston, MA, USA
| | - Deirdre E Logan
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston University, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Neil L Schechter
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura E Simons
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston University, Boston, MA, USA
- Boston Children’s Hospital, Center for Pain and the Brain, PAIN Research Group, Boston University, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Measuring Somatic Complaints in Primary School Children: Validation and Revision of the German Children's Somatization Inventory (CSI) and its Parental Version. Child Psychiatry Hum Dev 2015; 46:786-99. [PMID: 25416581 DOI: 10.1007/s10578-014-0520-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The objective was a psychometric examination of a German translation of the Children's Somatization Inventory (CSI) and its parents' version (P-CSI) and a replication of the item selection process of Walker et al. in J Pediatr Psychol 34:430-440 [5] for their revised version to create shorter German versions. Based on a school sample of 1,539 parents and 731 children, we explored the psychometric properties and dimensionality of the original and a shortened revised version. A clinical sample of 70 parental reports served as an additional sample. Walker et al.'s item selection could be largely replicated. Dimensionality differed between samples and versions (original vs. revised), but original DSM-III symptom clusters could mostly be identified. Symptom intensity was associated with age and mental health. Internal consistency, test-retest- and inter-rater reliability were good. Both German versions, the CSI and the P-CSI can be regarded as a useful screening instrument for somatic complaints in children.
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