Adolescents with functional somatic syndromes: Symptom profiles, illness perception, illness worry and attachment orientation

Abstract

ObjectiveTo describe patterns of somatic symptoms, illness perception, illness worries and attachment in adolescents with functional somatic syndromes (FSS) in comparison with a population-based sample of adolescents. MethodsSelf-reported and clinical data were collected from two studies: 1) Adolescents aged 15-19 with multiple FSS of at least 1 year's duration (n = 91) from the trial AHEAD (Acceptance and Commitment Therapy for Health in Adolescents). 2) A sex-matched population-based sample of adolescents (n = 1573) derived from the 16-17-year follow-up of the Copenhagen Child Cohort 2000 (CCC2000), including a subgroup with high somatic symptom-load (n = 155). ResultsSymptom patterns were similar across groups, but somatic symptoms were approximately 2-3-fold more common in AHEAD compared to CCC2000, with the exception of neurological symptoms, i.e. ‘moving pain’, ‘unpleasant numbness or tingling sensation’ and ‘feeling of paresis’ which were 6.5-9.0 times higher in AHEAD. Adolescents from AHEAD reported considerably more negative illness perception and illness worry compared to both the CCC2000 sample and the high symptom subgroup. Levels of attachment avoidance and anxiety, respectively, were similar in AHEAD as compared with CCC2000 but lower compared to the high symptom subgroup of CCC2000. ConclusionSimilar symptom profiles in AHEAD and CCC2000 support the concept of a general (i.e. not syndrome-specific) factor for symptom development in FSS. Functional neurological symptoms may be useful indicators of clinical impairment. A high degree of negative illness perception and illness worry in youth may lead to healthcare seeking and should have a specific focus in assessment and treatment of youth with FSS.