Somatic symptoms as a marker for severity in adolescent depression

AIM

This study aims to investigate the prevalence of somatic symptoms in depressed adolescents and in their healthy peers. A second aim is to investigate the correlation, in the depressed adolescents, between the number of somatic symptoms and severe concurrent symptoms, signs and life events.

METHODS

The total population of 16-17 year olds - in the city of Uppsala - was screened for depression and then interviewed using a structured interview questionnaire. Depressed subjects and matched controls were identified. A total of 177 pairs were used for pair-wise analyses of somatic symptoms. Severe symptoms, signs and life events were selected for analysing their relation to depression with somatic symptoms.

RESULTS

The adolescents with depressive disorders experienced considerably more somatic symptoms than their healthy controls. The duration and depth of the depression correlated with the number of somatic symptoms. There was a strong correlation between depression with many somatic symptoms and suicidal plans/thoughts, suicidal attempts, disruptive behaviour, as well as multiple stressful relationships.

CONCLUSION

This study demonstrates that somatic symptoms are common in adolescent depression. Multiple somatic symptoms within depression imply a higher severity in terms of duration, depth and psychiatric comorbidity. The strong correlation with suicidal plans, suicidal attempts and disruptive behaviour is concerning.

Traumatic Experiences and Post-traumatic Stress Symptoms in Kurdish Children in their Native Country and in Exile

BACKGROUND

  Traumatic experiences and post-traumatic stress symptoms were assessed in Kurdish children in their native country and in exile.

METHOD

  312 randomly selected school-age children at two sites completed assessments of traumatic experiences and post-traumatic symptoms.

RESULTS

  Although traumatic experiences showed more similarities than differences between the two samples, the PTSD frequencies and post-traumatic stress symptom scores were higher in Kurdistan than in exile. Living in exile showed negative correlation with PTSD frequencies and post-traumatic stress symptom scores.

CONCLUSIONS

  Living in exile seems to have trauma healing effect on children of Kurdistan.

Perceived and individual ideals of gender in Swedish adolescents with and without an eating disorder

Three open-ended questions based on Steiner-Adair (1986) were used to study gender concepts in relation to ideals in adolescent boys and girls and eating-disordered girls. The answers were coded according to themes emanating from the collected data and not predetermined. Dichotomous differences were found between the genders regarding perceived ideals of body size, but clinical and nonclinical girls perceived ideals of society and media similarly. Individual gender concepts differed substantially from the perceived ideals, and were most often focused on lifestyle and life conditions. However, the clinical girls were somewhat more likely to emphasize appearance and loving relationships.

Suicide and suicide attempts in adolescent-onset psychotic disorders

Eighty-eight subjects with adolescent-onset psychotic disorders (mean age+/-standard deviation 15.7+/-1.5 years), mainly schizophrenia and affective disorders, were followed up 10.6+/-3.6 years later, rediagnosed (DSM-IV) and assessed with the Positive and Negative Symptom Scale, abuse of drugs including nicotine, the Lancashire Quality of Life Profile and occurrence of suicide or suicide attempts. Four males (4.5% of subjects) had died from suicide while another 25% of the subjects had attempted suicide. Suicide attempts were associated to more depressive symptoms but fewer negative symptoms at first episode, and to number of admissions and to dependence on nicotine at follow-up in a logistic regression. Satisfaction with religion, health, family relations and safety at follow-up were inversely associated to attempting suicide but only satisfaction with religious belief remained after controlling for concurrent symptoms of anxiety and depression.

Adult outcome of social function in adolescent-onset schizophrenia and affective psychosis

OBJECTIVE

To examine and compare the adult outcome in a representative sample of hospitalized adolescent-onset psychoses including occupational and social aspects.

METHOD

A total of 81 patients with a first episode of early-onset psychosis (before age 19 years) presenting to the University Hospital of Lund, Sweden, between 1982 and 1993 were followed up an average of 10.5 years (range 5.1-18.2) after admission. Initial diagnosis was assessed from records and consisted of DSM-IV schizophrenia (n = 32), schizoaffective disorder (n = 7), bipolar disorder (n = 25), and major depressive disorder with psychotic features (n = 17). All could be traced and assigned a major outcome group.

RESULTS

Early-onset schizophrenia spectrum disorder suffered a chronic course with a poor outcome in 79% of the cases, while early-onset affective psychosis in 74% showed a good or intermediate outcome. The poor outcome (26%) in the affective group was connected to mental retardation in 7% and to progression to a schizoaffective disorder in 12%. A particularly severe outcome was seen for schizophrenia spectrum patients with a family history of nonaffective psychosis.

CONCLUSIONS

Early-onset schizophrenia spectrum disorder showed a severe course while affective psychoses had a much more benign functional outcome.

Do Kurdistanian and Swedish parents and children differ in their rating of competence and behavioural problems?

OBJECTIVE

This paper investigates child self-rating of behavioural problems and competence as compared with their parents' ratings, in comparative samples of Kurdistanian refugee children in Sweden and a group of Swedish children.

METHOD

Kurdistanian and Swedish comparative samples composed of 32 children each matched in age, sex and trauma level, in the same community, and their parents. Among a large battery of instruments, the child behavioural checklist (CBCL) was used in separate interviews with parents and their children.

RESULTS

When compared to the children's self-reported problems scores, the Swedish parents reported significantly lower scores than their children, compared to the Kurdistanian refugee parents.

CONCLUSION

Regardless of cultural backgrounds, there were more similarities than differences in the children's reporting of their behavioural problems and competence. The discrepancy between the Swedish parents' estimation of their children's behavioural problems and the children's self-reported behavioural problems could be an effect of the individualistic nature of Swedish society compared with the more collective nature of Kurdistanian culture. However, the results should be considered hypothesis generating rather than conclusive.