Functional Somatic Symptoms and Consultation Patterns in 5- to 7-Year-Olds

Abstract

OBJECTIVE: To investigate the frequency of and factors linked to medical consultation for functional somatic symptoms (FSS) among 5- to 7-year-old children. METHODS: We assessed 1327 children from the Copenhagen Child Cohort 2000 for FSS at ages 5 to 7 years. Register data on past health care use in general practice were compared between children with and those without parent-reported medical consultation for FSS at the age of 5 to 7 years: respective consulters (n = 96) and nonconsulters (n = 211) and children without FSS (n = 1019). Degree of parental worries about the child’s symptoms and parent-reported symptom characteristics and associated impacts were compared between consulters and nonconsulters. RESULTS: Among 308 children with FSS, 31.1% were consulters. Being a consulter was significantly associated with multisymptomatic presentation, parental worries about the symptoms, symptom impact, and a higher past health care use in general practice. Multiple logistic regression analysis controlled for gender, comorbid physical disease, and symptom severity revealed that the number of face-to-face contacts in general practice during the child’s first 4 years of life predicted being an consulter for FSS at 5 to 7 years (odds ratio 1.03, 95% confidence interval 1.00–1.06; odds ratio interpreted per unit change in number of contacts). CONCLUSIONS: This study adds to our understanding of health care use for FSS in childhood by highlighting the influence of parents’ early consultation patterns with their child and the influence of parental perceptions of their child’s health and FSS-related impact on pediatric health care use for FSS. Management of health care use in children with FSS should address these aspects.

Impact of functional somatic symptoms on 5–7-year-olds' healthcare use and costs

“…Furthermore, all other studies used the number of contacts to various specialties or any contact versus no contact as outcome5 6 8–14 16 18 19 34 35 38 as opposed to financial costs like the present study (table 5 can be used to ease comparability). We chose accumulated costs because they combine qualitatively different services into a single variable 1.…”

“…For a 5-year to 7-year follow-up, a random sample of 3000 cohort children was selected for comprehensive assessment, as this sample size was considered sufficient to estimate the population prevalence of psychiatric disease (data used elsewhere) 24. Complete data on FSS were available for 1327 children; one child died during the following 4.5 years, leaving 1326 in the final sample, which has been described previously 5 21 25 26…”

“…In childhood, FSS are common health complaints;4 a population-based study found a 1-year prevalence among children aged 5–7 years of 23%, with symptoms impairing daily life functioning in 4% of the sample 5…”

“…Previous studies have found increased use of overall healthcare9 10 or primary healthcare11 12 in children and adolescents with various FSS. Other health factors associated are multisymptomatic presentation of FSS,5 past healthcare use,5 health during the past year5 13 and well-defined physical illness and mental problems 9 11. General factors are the child’s gender,14 age,8 15 absence from school,9 11 parental health and psychopathology, parents' own healthcare use and socioeconomic status8–10 13–19 as well as ethnicity 10…”

Color Vision Deficiency and Functional Disorders Among Israeli Male Adolescents Between 2007 and 2013

“…They have been associated with emotional and behavioral problems as well as absence from school. 21,22 These syndromes are characterized by disproportionate and persistent thoughts and anxiety about one's symptoms with no organic reason, resulting in behavioral changes that interrupt daily life. The pathophysiology of these disorders is hardly understood, although they have been linked to a history of traumatic events, abuse in childhood, parental illness, and comorbid medical and psychiatric diseases.…”