Abstract
BackgroundThere is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms. Little is known about the long-term mental health outcomes associated with somatic symptoms or the temporal relationship between depression and such symptoms. This 15-year study followed up adolescents with depression and matched controls, screened from a population-based sample, who reported different numbers of somatic symptoms.MethodsThe total population of 16–17-year-olds in Uppsala, Sweden, was screened for depression in 1991–1993. Adolescents who screened positive and an equal number of healthy controls took part in a semi-structured diagnostic interview. In addition, 21 different self-rated somatic symptoms were assessed. Sixty-four percent of those adolescents participated in a follow-up structured interview 15 years later.ResultsSomatic symptoms in adolescence predicted depression and other adult mental disorders regardless of the presence of adolescent depression. In adolescents with depression, the number of functional somatic symptoms predicted, in a dose response relationship, suicidal behavior, bipolar episodes, and psychotic episodes as well as chronic and recurrent depression. Contrary to expectations, the somatic symptoms of abdominal pain and perspiration without exertion better predicted depression than all DSM-IV depressive symptoms. Abdominal pain persisted as an independent strong predictor of depression and anxiety, even after controlling for other important confounders.ConclusionsSomatic symptoms in adolescence can predict severe adult mental health disorders. The number of somatic symptoms concurrent with adolescent depression is, in a stepwise manner, linked to suicidal attempts, bipolar disorders, psychotic disorders, and recurrent and chronic depression. These findings can be useful in developing treatment guidelines for patients with somatic symptoms.
Highlights
There is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms
There was a linear relationship between number of somatic symptoms in adolescence with depression and the risk of mental disorders as adults for any disorder (p < 0.001), any mood disorder (p < 0.001), recurrent depression (p < 0.001), chronic depression (p < 0.05), bipolar disorders (p < 0.05), any anxiety disorder (p < 0.05), panic disorder (p < 0.05), and somatoform disorders (p < 0.01)
Adolescents with depression and ≥ 5 somatic symptoms (23% of the depressed) had marked adverse adult mental health outcomes compared to the other groups (Table 2)
Summary
There is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms. Little is known about the long-term mental health outcomes associated with somatic symptoms or the temporal relationship between depression and such symptoms. This 15-year study followed up adolescents with depression and matched controls, screened from a population-based sample, who reported different numbers of somatic symptoms. One third of patients in primary health care suffer from multiple somatic symptoms, representing the main reason for consultation [1,2]. These patients are distinguishable from patients with explained medical disorders. In patients with depression and cardiovascular disease, somatic and not affective/cognitive symptoms of depression are predictive of earlier death or cardiac events [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
