Abstract
The aim of this study is at examining the prevalence and impact factors of adolescent somatization tendencies (ST) across three eastern Chinese provinces. A multicenter school-based cross-sectional study was conducted in these provinces from 2015 to 2016. The sample included 11,153 middle-school students aged 13-18 years, who were randomly selected using a multi-phase stratified cluster sampling technique. We also designed a multicenter school-based case-control study to evaluate the potential environmental impact of ST factors on this population. The overall positive rate of ST among the eastern Chinese adolescents was 12.1%. Somatic symptoms score (SSS) and positive ST rate were higher in females than males. Additionally, the SSS and positive ST rate for the 18-year-old group were significantly higher than in other age groups. In comparison to those in urban areas, adolescents in rural areas had significantly higher SSS and positive ST rate. Multiple conditional regression analyses revealed that family medical history, anxiety and depression scores; superstitious beliefs; left-behind adolescents; teacher-student support; family conflict; and family independence and achievement orientation were significantly linked to ST in adolescents. The models also indicated family medical history was the strongest impact factor to adolescent ST, even though ST were prevalent in the three studied eastern Chinese provinces. Gender, age, and dwelling differences were very significant in the SSS and positive ST rate in adolescents. This study concludes that adolescent ST are influenced by multiple environments.
Highlights
As originally described in the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), the somatization disorder (SD) is characterized by a wide variety of somatic symptoms affecting different organ systems
We found that younger females from specific ethnocultural groups, with certain family medical histories or who have endured childhood sexual abuse, substance abuse, anxiety and depressive disorders or traumatic events are at an increased risk for adolescent SD 3,4
Kihlstrom et al 33 report that the prevalence of dissociative tendencies in adolescents lies between 10% and 19%; results similar to those of our study
Summary
As originally described in the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), the somatization disorder (SD) is characterized by a wide variety of somatic symptoms affecting different organ systems. The SD, characterized by complaints of unexplained physical symptoms, is commonly present in children and adolescents in both primary and secondary care settings. This disorder significantly impacts children, as well as healthcare resources: such as in adults, there is a wide range of severity and handicaps resulting from SD 3. In studies from some European countries, the reported prevalence of SD ranged from 0.1% to 0.8% in the general Western population [6,7]. Epidemiological studies of adolescents aged [13,14,15,16,17,18] years conducted in Oman and the Philippines found higher prevalence rates of SD compared with Western countries 8
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