Discordance between Adolescents and Parents in Functional Somatic Symptom Reports: Sex Differences and Future Symptom Prevalence

Abstract

Functional somatic symptoms, i.e., physical complaints that cannot be sufficiently explained by an objectifiable biomedical abnormality, become increasingly more prevalent in girls than in boys during adolescence. Both parents and adolescents report more functional somatic symptoms in girls, but their reports correspond only limitedly. It remains unknown whether parent-adolescent discordance contributes to the higher symptom prevalence in girls. This study investigated parent-adolescent discordance in reported functional somatic symptoms throughout adolescence, examined the longitudinal association of parent-adolescent discordance with symptom prevalence in early adulthood and focused on sex differences in these processes. Participants included 2229 adolescents (50.7% female) from four assessments (age 11 to 22 years) of the TRAILS population cohort. Parents and adolescents reported significantly more symptoms in girls than in boys during adolescence. Variance analyses showed that throughout adolescence, parents reported fewer symptoms than girls self-reported and more than boys self-reported. Regression analyses using standardized difference scores showed that lower parent-report than self-report was positively associated with symptom prevalence in early adulthood. Polynomial regression analyses revealed no significant interaction between parent-reported and adolescent self-reported symptoms. Associations did not differ between boys and girls. The findings show that lower parent-reported than self-reported symptoms predict future symptom prevalence in both sexes, but this discordance was more observed in girls. The higher functional somatic symptom prevalence in girls might be partly explained by parental underestimation of symptoms.

Exploring the course of functional somatic symptoms (FSS) from pre- to late adolescence and associated internalizing psychopathology – an observational cohort-study

“…Child sex assigned at birth (i.e. ‘male’/‘female’) was obtained from the Danish Civil Registry [ 69 ], and was used as covariate in the analyses to adjust for potential sex-specific differences in FSS development and expression in adolescence [ 58 , 70 ]. Parental education at age 11/12 was derived from the Integrated Labor Market Registry [ 71 ], and categorized according to either parent’s highest education level, i.e.…”

Gender scores in epidemiological research: methods, advantages and implications

“… 1 The effects of sex and gender of patients are seen across symptoms, 2 diseases, 1 and throughout all phases of the patients’ illness trajectories. Differences between women and men are identified in the biopsychosocial etiology and persistence of somatic symptoms, 3 , 4 , 5 help-seeking behaviors, 6 medical communication about symptoms, 7 provided diagnostic interventions, 8 and efficacy of treatment. 9 …”