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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2012; 12: 90.
Published online Jul 27, 2012. doi:  10.1186/1471-244X-12-90
PMCID: PMC3439696
Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers
Hannes Bohman,corresponding author1 Ulf Jonsson,1,2 Aivar Päären,1 Lars von Knorring,2 Gunilla Olsson,1 and Anne-Liis von Knorring1
1Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, SE-75185, Uppsala, Sweden
2Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
corresponding authorCorresponding author.
Hannes Bohman: Hannes.Bohman/at/neuro.uu.se; Ulf Jonsson: ulf.jonsson/at/neuro.uu.se; Aivar Päären: aivar.paaren/at/neuro.uu.se; Lars von Knorring: lars.von_knorring/at/neuro.uu.se; Gunilla Olsson: ig.olsson/at/neuro.uu.se; Anne-Liis von Knorring: anne-liis.von_knorring/at/neuro.uu.se
Received November 21, 2011; Accepted July 17, 2012.
Abstract
Background
There is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms. Little is known about the long-term mental health outcomes associated with somatic symptoms or the temporal relationship between depression and such symptoms. This 15-year study followed up adolescents with depression and matched controls, screened from a population-based sample, who reported different numbers of somatic symptoms.
Methods
The total population of 16–17-year-olds in Uppsala, Sweden, was screened for depression in 1991–1993. Adolescents who screened positive and an equal number of healthy controls took part in a semi-structured diagnostic interview. In addition, 21 different self-rated somatic symptoms were assessed. Sixty-four percent of those adolescents participated in a follow-up structured interview 15 years later.
Results
Somatic symptoms in adolescence predicted depression and other adult mental disorders regardless of the presence of adolescent depression. In adolescents with depression, the number of functional somatic symptoms predicted, in a dose response relationship, suicidal behavior, bipolar episodes, and psychotic episodes as well as chronic and recurrent depression. Contrary to expectations, the somatic symptoms of abdominal pain and perspiration without exertion better predicted depression than all DSM-IV depressive symptoms. Abdominal pain persisted as an independent strong predictor of depression and anxiety, even after controlling for other important confounders.
Conclusions
Somatic symptoms in adolescence can predict severe adult mental health disorders. The number of somatic symptoms concurrent with adolescent depression is, in a stepwise manner, linked to suicidal attempts, bipolar disorders, psychotic disorders, and recurrent and chronic depression. These findings can be useful in developing treatment guidelines for patients with somatic symptoms.
Keywords: Adolescent depression, Long-term follow-up, Functional somatic symptoms, Anxiety and suicidal behavior
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