Factors associated with internalizing or somatic symptoms in a cross-sectional study of school children in grades 1-10

Audhild Løhre,Lars J Vatten,Stian Lydersen

doi:10.1186/1753-2000-4-33

Abstract

BackgroundSchool related factors that may contribute to children's subjective health have not been extensively studied. We assessed whether factors assumed to promote health and factors assumed to have adverse effects were associated with self-reported internalizing or somatic symptoms.MethodsIn a cross-sectional study, 230 boys and 189 girls in grades 1-10 from five schools responded to the same set of questions. Proportional odds logistic regression was used to assess associations of school related factors with the prevalence of sadness, anxiety, stomach ache, and headache.ResultsIn multivariable analyses, perceived loneliness showed strong and positive associations with sadness (odds ratio, 1.94, 95% CI 1.42 to 2.64), anxiety (odds ratio, 1.78, 95% CI 1.31 to 2.42), and headache (odds ratio, 1.47, 95% CI 1.10 to 1.96), with consistently stronger associations for girls than boys. Among assumed health promoting factors, receiving necessary help from teachers was associated with lower prevalence of stomach ache in girls (odds ratio, 0.51, 95% CI 0.30 to 0.87).ConclusionsThese findings suggest that perceived loneliness may be strongly related to both internalizing and somatic symptoms among school children, and for girls, the associations of loneliness appear to be particularly strong.

Highlights

School related factors that may contribute to children’s subjective health have not been extensively studied
In separate analyses by gender, no clear associations with headache were present for boys, but among girls, being disturbed in school work and loneliness were both strongly and positively associated with the prevalence of headache. In this cross-sectional study of self-reported internalizing and somatic symptoms among more than 400 school children, we found that perceived loneliness was strongly associated with the prevalence of sadness, Table 3 Proportional odds logistic regression with anxiety as dependent variable
A strong association of loneliness with anxiety and headache among adolescent girls, but not in boys, whereas for sadness, there was a clear association of loneliness for both genders. In this population study of children between 7 and 16 years of age, perceived loneliness appears to be of special importance in relation to internalizing and somatic symptoms, and for girls, perceived loneliness may be important in relation to emotional distress and physical complaints

Summary

Introduction

School related factors that may contribute to children’s subjective health have not been extensively studied. Health complaints are typically classified as either emotional or somatic, and a combination of these types of symptoms is not uncommon [5,6,7,8,9,10]. Anxiety and depression are the most common emotional problems, and appear to be more prevalent among girls, with fairly high co-morbidity (20-50%) [11]. Depressive disorders are rare among young children, but in adolescence the prevalence may be as high as 8% [11]. The results of long term followup studies suggest that early emotional symptoms may Headache and stomach pain are the most prevalent physical complaints at a young age [15]. Children rarely complain about headache [16], but the prevalence increases with age [10,17,18]. The prevalence of reported headache seems to be higher in boys than girls, but after puberty, the prevalence appears to be higher among girls [17,18]

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Results

Discussion

Conclusion