Abstract

In the adult population, psychiatric disorders are associated with somatic illness. Explanatory life style factors have been found, but also a failure to recognize somatic illness in this group. Another factor is side effects from long-term use of antipsychotic drugs. Given the psychiatric-somatic comorbidity in the adult population, it is of interest to investigate whether an association exists already during childhood. The aim of the present study was to investigate the frequency of somatic illness in children and adolescents with a psychiatric diagnose. Data were obtained from the regional health care database Vega, Sweden. Psychiatric and somatic diagnoses obtained during 2011–2013 for individuals aged 3–18 years were extracted. Descriptive statistics were used to examine difference in somatic morbidity between children with and without psychiatric diagnoses. Logistic regression was used in age-stratified models to test the association between psychiatric and somatic diagnoses. Anxiety and behavioral disorders were associated with all somatic conditions investigated at nearly all ages. The same applied to substance use, investigated at age 9–18 years. Affective disorders were associated with all somatic conditions at age 12–18 years. Psychotic conditions were associated with asthma, bowel disorders and myalgia in adolescents. Children with psychiatric disorders are at remarkably high risk for concurrent somatic illness. The associations span across many types of conditions and across all ages. The results support the need for awareness of somatic morbidity in child and adolescent psychiatric clinical settings, and the need for coordinated health care for children with comorbid states.

Highlights

  • Psychiatric disorders, such as depression and schizophrenia, are associated with increased somatic morbidity and mortality among adults [1]

  • Notable differences were found in frequencies of obesity, where 4.5% (n = 64) of children aged 12–14 years with anxiety were diagnosed with obesity compared to 1.6% (n = 754) of children the same age without anxiety (Pearson χ2 69.18, p < 0.001)

  • Detection of somatic illness or risk factors for chronic conditions could contribute to the implementation of interventions, and further on possible preventive measures in high risk groups

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Summary

Introduction

Psychiatric disorders, such as depression and schizophrenia, are associated with increased somatic morbidity and mortality among adults [1]. Previous studies have shown increased mortality in ischemic heart disease [2] and shorter life span in adults diagnosed with severe mental illness [3, 4]. Stigmatization and cognitive difficulties might hinder the establishment of health care contacts, to follow treatment regimens and screening programs [5]. Organizational structures that complicate cooperation between somatic and psychiatric health care as well as lack of knowledge about psychiatric-somatic comorbidity are other hindering factors [6]. Prolonged use of antipsychotic drugs known to be associated with metabolic side effects [8], and economic disadvantage resulting in non-adherence to medical treatments and health care

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