Somatic Complaints in Anxious Youth

Abstract

This study examined (a) demographic and clinical characteristics associated with physical symptoms in anxiety-disordered youth and (b) the impact of cognitive-behavioral therapy (Coping Cat), medication (sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7–17 years) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi-site, randomized controlled trial and received treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research are discussed. (ClinicalTrials.gov number, NCT00052078)

Efficacy and Tolerability of Antidepressants in Pediatric Anxiety Disorders: A Systematic Review and Meta-Analysis

“…In this regard, while studies of SSRIs and SSNRIs in adults with anxiety disorders have generally observed high rates of gastrointestinal symptoms, we failed to observe a significantly increased risk of these symptoms in anxious youth who were treated with antidepressants. This may owe to the heterogeneity in reporting of these symptoms in the trials that were examined (e.g., nausea vs. abdominal pain + nausea vs. vomiting + nausea) and may also relate to the relatively high rates of gastrointestinal symptoms in youth with untreated anxiety . Additionally, in this meta‐analysis, activation strongly trended toward being more likely with antidepressant treatment compared to placebo treatment.…”

“…Thus, medication dose (or plasma drug concentration) appears to influence the likelihood of treatment‐emergent activation. More generally, regarding side effects in anxious youth, it is important to emphasize that pediatric patients with anxiety disorders have high rates of somatic symptoms prior to treatment and that the severity of these symptoms vary directly with the severity of the anxiety symptoms and importantly decrease with treatment . Additionally, differences in antidepressant‐treated adult patients with anxiety disorders and those with depressive disorders have been observed, suggesting that either the presence of an anxiety disorder may increase the likelihood of experiencing or perceiving side effects.…”

Emotional and Behavioral Problems Among Impoverished Kenyan Youth: Factor Structure and Sex-Differences

“…We hypothesize that girls will report higher internalizing symptoms and boys may report higher externalizing symptoms, based on the multicultural data detailing patterns of internalizing and externalizing symptoms of girls and boys from other societies (Achenbach and Rescorla 2010). We hypothesize that our Kenyan youth sample will report higher levels of somatic symptoms, based on studies finding youth exposed to trauma, violence, stress, adversity, and mental problems have high levels of somatic symptoms (Bailey et al 2005; Crawley et al 2013; Gobble et al 2004; Hensley and Varela 2008; Shaw 2003). Within Kenyan youth, we also expect to find higher levels of YSR symptoms among a clinic-based sample compared to a random sample (Achenbach and Rescorla 2001, 2010).…”

Primary Pediatric Care Psychopharmacology: Focus on Medications for ADHD, Depression, and Anxiety

“…Of note, meta-analytic evaluations of these side effects have generally failed to detect treatment-related differences in the frequencies of these events. 12 This may, however, relate to the heterogeneity in reporting of these symptoms and may also relate to the relatively high rates of gastrointestinal symptoms, headaches and other somatic symptoms in youth with untreated anxiety 65 and depressive disorders as the putative relationship between some antidepressants and plasma drug concentrations (e.g., venlafaxine). Class-related side effects include increases in heart rate and small increases in blood pressure associated with SSNRI treatment in youth.…”