Predictors for persistence of functional somatic symptoms in adolescents

Objective: To identify risk factors for persistence of functional somatic symptoms (FSS; ie, somatic symptoms that cannot be sufficiently explained by underlying organic pathology).

Study design: The first (N = 2230, mean age = 11.1 years [SD 0.6], 50.8% girls), second (N = 2149, mean age = 13.7 years [SD 0.5], 51.0% girls), and third (N = 1816, mean age = 16.3 years [SD 0.7], 52.3% girls) assessment waves of the general population study TRacking Adolescents' Individual Lives Survey were used. FSS were assessed with the Youth Self-Report and the Child Behavior Checklist. Growth mixture models were used to identify different subgroups of adolescents on the basis of the developmental trajectory of their symptoms. Adolescents with persistent symptoms were compared with adolescents with decreasing symptoms with a multivariable logistic regression analysis.

Results: In our general population cohort, 4.1% of adolescents suffered from persistent FSS. Risk factors for persistent FSS were being a girl (OR 4.69, 95% CI 2.17-10.12), suffering from depressive symptoms (OR 5.35, 95% CI 1.46-16.62), poor self-rated health (OR 1.56, 95% CI 1.02-2.39), and high parent-reported FSS (OR 4.03, 95% CI 1.20-13.54). Anxiety, parental overprotection, school absenteeism, and diversity of symptoms did not predict persistence of FSS.

Conclusions: This study identified risk factors for persistence of FSS in adolescents. Future studies might study effects of coping strategies and iatrogenic factors on symptom persistence.