Somatic comorbidity in children and adolescents with psychiatric disorders

Abstract

In the adult population, psychiatric disorders are associated with somatic illness. Explanatory life style factors have been found, but also a failure to recognize somatic illness in this group. Another factor is side effects from long-term use of antipsychotic drugs. Given the psychiatric-somatic comorbidity in the adult population, it is of interest to investigate whether an association exists already during childhood. The aim of the present study was to investigate the frequency of somatic illness in children and adolescents with a psychiatric diagnose. Data were obtained from the regional health care database Vega, Sweden. Psychiatric and somatic diagnoses obtained during 2011-2013 for individuals aged 3-18 years were extracted. Descriptive statistics were used to examine difference in somatic morbidity between children with and without psychiatric diagnoses. Logistic regression was used in age-stratified models to test the association between psychiatric and somatic diagnoses. Anxiety and behavioral disorders were associated with all somatic conditions investigated at nearly all ages. The same applied to substance use, investigated at age 9-18 years. Affective disorders were associated with all somatic conditions at age 12-18 years. Psychotic conditions were associated with asthma, bowel disorders and myalgia in adolescents. Children with psychiatric disorders are at remarkably high risk for concurrent somatic illness. The associations span across many types of conditions and across all ages. The results support the need for awareness of somatic morbidity in child and adolescent psychiatric clinical settings, and the need for coordinated health care for children with comorbid states.

Psychiatric morbidity, somatic comorbidity and substance use in an adolescent psychiatric population at 3-year follow-up

“…A systematic review demonstrated a strong positive association between chronic somatic disorders in adolescence and anxiety and depressive disorders [16]. A recent population-based Swedish study reported a high risk for concurrent somatic disorders in children with psychiatric disorders, across all ages and across many types of conditions [17].…”

Schizotypy, Lifestyle Behaviors, and Health Indicators in a Young Adult Sample

“…Somatic symptoms can simply represent the bodily manifestation of distress that accompanies a wide range of mental health issues (e.g., depression and anxiety) [ 64 ]. However, two well-designed population studies found a significant concurrence of somatic symptoms and psychosis in pre-adolescent and adolescent research participants [ 16 , 65 ]. The relationship between somatic symptoms and psychotic-like experiences appeared to be independent of anxiety or other forms of psychopathology, possibly representing anomalous interpretations of bodily experiences [ 16 ].…”

Why We Need a Developmentally Appropriate Trauma Diagnosis for Children: a 10-Year Update on Developmental Trauma Disorder

“…The DTD domain of affective/somatic dysregulation (Criterion B) includes four symptoms that are based on research showing that maladaptive emotion processing and emotion dysregulation are a link between childhood adversity and subsequent psychopathology extending into adolescence and adulthood (Aldao et al, 2016;Beauchaine & Cicchetti, 2019;Conway et al, 2018;Heleniak et al, 2016b;McLaughlin et al, 2020;Schaefer et al, 2021;Weissman et al, 2019). Somatic dysregulation (i.e., impairment in or pain related to basic bodily functions) was included in this domain based on to evidence that children may express emotional distress indirectly through somatic complaints and somatoform symptoms (Agnafors et al, 2019;Flaherty , 2013;Ford et al, 2013b;Vernberg et al, 2011). In addition, adults (Eslami et al, 2019;Littleton, 2015;Paras et al, 2009) and adolescents (Bonvanie et al, 2015;Espejo-Siles et al, 2020;Nixon et al, 2011;Rey et al, 2020) with a history of childhood sexual abuse or peer victimization are at risk for stress-related somatic complaints and bodily problems (i.e., functional gastrointestinal disorders, chronic nonspecific and pelvic pain, psychogenic seizures).…”