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Petri L, Poulain T, Vogel M, Meigen C, Kiess W, Hiemisch A. Parent-perceived recurrent pain in children: associations with maternal pain, depressiveness, socioeconomic status, and children's behavioural difficulties. Front Pediatr 2024; 12:1287343. [PMID: 38379914 PMCID: PMC10876899 DOI: 10.3389/fped.2024.1287343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/15/2024] [Indexed: 02/22/2024] Open
Abstract
Objectives The current study aimed to examine the potential transgenerational associations between maternal pain and depressiveness and childhood pain, and to explore the associations between the children's difficulties and recurrent pain (defined as pain occurring at least once a month in the previous 6 month) in healthy children aged 3-13 years. Methods We collected Data between 2015 and 2019 as part of the LIFE Child study in Germany and investigated associations of maternal pain and depressiveness, child age, sex, pubertal stage, emotional difficulties, conduct difficulties, hyperactivity/inattention, peer group difficulties, and prosocial skills, and family socioeconomic status with the frequency of parent-perceived headache, backache, and stomachache in a sample of 1,850 children (4,819 documented visits) using logistic and ordinal regression analyses. Results Overall, 10.4%, 24.4%, and 45.2% of parents reported their children had recurrent backache, headache, and stomachache, respectively, with 5.5% of children were reported to experience all three types of pain simultaneously. Higher age, female sex, puberty, emotional difficulties, low family socioeconomic status, as well as higher maternal impairment due to pain and maternal depressiveness were significantly associated with more frequent pain. Conclusions Our study suggests that maternal pain, maternal depressiveness, and lower family socioeconomic status as well as child's emotional difficulties are significantly associated with a higher frequency of recurrent pain in children perceived by their parents.
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Affiliation(s)
- Laura Petri
- LIFE Child—Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Tanja Poulain
- LIFE Child—Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - Mandy Vogel
- LIFE Child—Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - Christof Meigen
- LIFE Child—Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Wieland Kiess
- LIFE Child—Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - Andreas Hiemisch
- LIFE Child—Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
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Barends H, van der Wouden JC, Claassen-van Dessel N, Twisk JWR, van der Horst HE, Dekker J. Potentially traumatic events, social support and burden of persistent somatic symptoms: A longitudinal study. J Psychosom Res 2022; 159:110945. [PMID: 35665613 DOI: 10.1016/j.jpsychores.2022.110945] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Psychological trauma is a well-known risk factor for the onset of persistent somatic symptoms (PSS). In contrast, little is known on the relation between potentially traumatic events (PTEs) and the severity of PSS, and on the protective effect of social support. We aimed to: (i) determine whether childhood, adulthood and recent PTEs are associated with burden of PSS over four years of follow-up; (ii) examine associations of multiple and cumulative (in childhood and adulthood) exposure to PTEs with burden of PSS; and (iii) determine whether social support modifies these associations. METHODS Longitudinal data of 322 patients with PSS were analyzed. PTEs (Life Events Questionnaire) and social support (Social Support Scale) were assessed at baseline. Burden of PSS was measured in terms of symptom severity (PHQ-15) and physical functioning (RAND-36 PCS) at six repeated measurements over a four-year interval. Associations were analyzed using longitudinal mixed model analysis. RESULTS Patients with multiple childhood PTEs reported higher burden of PSS over four-year time. Adulthood PTEs were associated with burden of PSS in patients with, but not in patients without childhood PTEs. Recent PTEs were not associated with burden over time. Social support did not modify any of the associations. CONCLUSIONS PTEs are associated with higher burden of PSS over time, in addition to the well-known association with the onset of PSS. PTEs in early life and cumulative exposure to PTEs in childhood and adulthood are associated with higher burden over time in patients with PSS. Social support did not attenuate the associations.
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Affiliation(s)
- Hieke Barends
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands.
| | - Johannes C van der Wouden
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Nikki Claassen-van Dessel
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Jos W R Twisk
- Amsterdam Public Health research institute, Amsterdam, the Netherlands; Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - Henriëtte E van der Horst
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Joost Dekker
- Amsterdam Public Health research institute, Amsterdam, the Netherlands; Department of Rehabilitation Medicine and Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
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Nilsen SA, Hysing M, Breivik K, Heradstveit O, Vingen Sunde E, Stormark KM, Bøe T. Complex families and health complaints among adolescents: A population-based cross-sectional study. Scand J Public Health 2019; 48:733-742. [PMID: 31830876 DOI: 10.1177/1403494819893903] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: The structure of adolescents' families has become more complex over the last decades in several western countries. In parallel, health complaints among adolescents appear to have risen in the Nordic countries. This study aimed to examine the association between family structure and health complaints among Norwegian adolescents while capturing biological, half-, and stepsiblings (sibship-type) in the families. Methods: Data stem from the youth@hordaland study, an epidemiological study of adolescents aged 16-19 years (N = 10,257; participation rate = 53%) conducted in 2012. This study is based on a subsample of 8808 adolescents who lived with parent(s). The adolescents provided detailed information on sociodemographics, family structure, sibship-type, and common health complaints among youth (headache, dizziness, and abdominal, neck, back, and shoulder pain). Results: Adolescents in nuclear families and joint physical custody (JPC) reported significantly lower levels of health complaints compared to peers in single- or stepparent families. Independent of family structure, biological siblings were associated with lower levels of health complaints, while stepsiblings were associated with higher levels of health complaints, but only among girls. These findings were robust to adjustments of sociodemographic variables. Conclusions: Health complaints are frequent but unequally distributed across family structures. Adolescents in nuclear families and JPC report lower levels of health complaints compared to peers in single- or stepparent families. Considering siblings appears to be relevant, as biological- and stepsiblings were related to adolescents' symptoms, independent of family structure. In combination, knowledge about family structure and sibship-type may aid the identification of adolescents at risk of experiencing health complaints.
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Affiliation(s)
- Sondre Aasen Nilsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Norway.,Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Norway.,Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Norway
| | - Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Norway.,Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Eilif Vingen Sunde
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Norway
| | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Norway.,Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Norway
| | - Tormod Bøe
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Norway.,Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
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Winding TN, Andersen JH. Do negative childhood conditions increase the risk of somatic symptoms in adolescence? - a prospective cohort study. BMC Public Health 2019; 19:828. [PMID: 31242885 PMCID: PMC6595570 DOI: 10.1186/s12889-019-7198-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 06/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background In order to prevent health and social problems later in life, it is important to identify childhood conditions related to the development of somatic symptoms. This prospective study expands on previous research by investigating whether negative childhood conditions are related to somatization later in life, taking other risk factors into account. This study aims to investigate whether somatic symptoms of the participants’ parents, poor family functioning, or negative life events during childhood result in somatic symptoms in early or late adolescence. Methods The study population includes participants from the West Jutland Cohort Study who responded to the survey on their somatic symptoms at age 15 (n = 2963) and/or age 18 (n = 2341). The study also includes additional questionnaire information about the participants’ poor family functioning, number of negative life events, and parental reports of somatic symptoms as well as register information about parental socioeconomic background. Generalized linear models for the binomial family were used and the results were presented as relative risks (RR) and risk differences (RD) with 95% confidence intervals (95%-CI). Results Experiencing poor family functioning at age 15 showed associations with somatic symptoms at age 15 (RR 1.75, 95%-CI, 1.43–2.14 and RD 18, 95%-CI, 11–25%) and 18 (RR 1.32, 95%-CI, 1.00–1.75 and RD 7, 95%-CI, 0.2–14%). The relative risks between poor family functioning and somatic symptoms were 2.5 for the boys at age 15 and 1.71 for the girls at age 18. Having experienced two or more negative life events up to the age of 15 was associated with reporting somatic symptoms at age 15 (RR 1.73, 95%-CI, 1.31–2.28 and RD 24, 95%-CI, 11–37%). No relative risks above 1.35 were found between parents reporting somatic symptoms and participants reporting somatic symptoms at ages 15 or 18. Conclusions An increased awareness of the association between a poor social climate in the family and somatic symptoms may help professionals in health and educational systems prevent the development of such symptoms among adolescents.
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Affiliation(s)
- Trine N Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Johan H Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
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Reddy B, Chaturvedi SK, Desai G, Manjunatha N, Guruprasad S. Health-related life events in patients with somatic symptom disorders: A case control study. Int J Soc Psychiatry 2019; 65:265-270. [PMID: 30969143 DOI: 10.1177/0020764019842278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The positive association between adverse life events and somatoform disorders is a consistent observation. But no systematic studies have evaluated the relationship between health-related life events (HLEs) in patients with somatic symptom disorder (SSD)/somatoform disorders. AIM To examine the nature and relationship of HLE in patients with SSD and to assess the correlates of HLE. METHODS A total of 50 adult patients with SSD and 50 matched healthy controls from a Neuropsychiatric hospital were recruited. Sociodemographic interview, scale for assessment of somatic symptoms (SASS), Patient Health Questionnaire-15 (PHQ-15) and a semi-structured interview schedule to gather information on HLE were used. RESULTS Patients in the SSD group had a significantly higher number of total HLE in general (4.72 ± 2.63, 3.36 ± 1.92; p = .004), major HLE (1.48 ± 1.45, 0.68 ± 0.94; p = .006), during their lifetime in comparison to controls. Infections, trauma, non-communicable diseases and reproductive system-related diseases were the more common types of HLE in SSD group. CONCLUSION Our findings may implicate a role of major HLE of patients and HLE of their family members in the pathophysiology of SSD.
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Affiliation(s)
| | - Santosh Kumar Chaturvedi
- 2 Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Geetha Desai
- 2 Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Narayana Manjunatha
- 2 Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Krause D, Stapf TM, Kirnich VB, Hennings A, Riemer S, Chrobok A, Fries DR, Pedrosa Gil F, Rief W, Schwarz MJ, Schmidmaier R. Stability of Cellular Immune Parameters over 12 Weeks in Patients with Major Depression or Somatoform Disorder and in Healthy Controls. Neuroimmunomodulation 2018; 25:7-17. [PMID: 29895009 DOI: 10.1159/000488353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 03/01/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Cellular immune status in major depression (MD) patients differs from that in somatoform disorder (SFD) patients and healthy controls (HC). It is still questionable whether the patterns of immune parameters remain stable over time. Therefore, we studied lymphocyte and monocyte cell counts and neopterin levels in peripheral blood of MD and SFD patients and HC over 12 weeks and tested for correlations between biochemical and psychometric parameters. METHODS Thirty-nine patients with MD, 27 with SFD, and 51 HC were recruited. Peripheral blood was drawn at four visits, at 4-week intervals. We assessed the total cell count of B lymphocytes, natural killer (NK) cells, T lymphocyte subpopu-lations, and monocytes by flow cytometry, and neopterin serum levels by ELISA. Psychometric parameters were measured with questionnaires. RESULTS Counts of lymphocytes, monocytes, and neopterin were stable in the SFD and HC groups. In the MD group, total CD3+, CD3+CD8+, NK cells, and CD3+CD25+ T cells showed inhomogeneous variances in Friedman tests, particularly in females. Neopterin correlated with depressed mood in MD patients, and with body mass index in HC. CONCLUSIONS Cellular immune parameters are stable in HC and SFD. Our results may indicate influences of MD and gender on some cellular immune parameters. This may need to be considered in future immunological studies.
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Affiliation(s)
- Daniela Krause
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Theresa M Stapf
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Verena B Kirnich
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Anika Hennings
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Sabine Riemer
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Agnieszka Chrobok
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Daniel R Fries
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | | | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Markus J Schwarz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ralf Schmidmaier
- Department of Hematology and Oncology, Medizinische Klinik Innenstadt, Klinikum der LMU, Munich, Germany
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Myrtveit Sæther SM, Sivertsen B, Haugland S, Bøe T, Hysing M. Health complaints in late adolescence; Frequency, factor structure and the association with socio-economic status. Scand J Public Health 2017; 46:141-149. [PMID: 28709386 DOI: 10.1177/1403494817711359] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIMS Little is known about social disparities in health in late adolescence. Among boys and girls aged 17-19, we aimed to (1) describe frequency of health complaints, (2) investigate the factor structure of health complaints and (3) examine the association between health complaints and socio-economic status (SES). METHODS Data from the large population-based youth@hordaland survey ( n=10,253) were used. Health complaints were assessed by five items from the Health Behaviour in School-Aged Children Symptoms Checklist, SES by parental education and perceived family economy. Associations between health complaints and SES were investigated using analysis of variance, and the factor structure of health complaints using confirmatory factor analyses. RESULTS At least one weekly complaint was reported by 47% of girls and 21% of boys. The items showed a good fit to a simple one-factor model when back pain and neck/shoulder pain were allowed to correlate. Health complaints were more frequent among adolescents reporting poor perceived family economy and lower parental education. CONCLUSIONS Our results suggest that health complaints are common in adolescence and might, as in adults, be part of everyday life. Health complaints are more frequent among adolescents from families with lower SES.
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Affiliation(s)
- Solbjørg Makalani Myrtveit Sæther
- 1 Departments of Clinical Science, University of Bergen, Norway.,2 Department of Health Promotion, Norwegian Institute of Public Health, Norway.,3 Departments of Global Public Health and Primary Care, University of Bergen, Norway
| | - Børge Sivertsen
- 2 Department of Health Promotion, Norwegian Institute of Public Health, Norway.,4 Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway.,5 Department of Research and Innovation, Helse Fonna HF, Norway
| | - Siren Haugland
- 4 Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway
| | - Tormod Bøe
- 4 Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway
| | - Mari Hysing
- 4 Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway
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Bonvanie IJ, Janssens KAM, Rosmalen JGM, Oldehinkel AJ. Life events and functional somatic symptoms: A population study in older adolescents. Br J Psychol 2016; 108:318-333. [DOI: 10.1111/bjop.12198] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 04/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Irma J. Bonvanie
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE); University of Groningen; University Medical Center Groningen; The Netherlands
| | - Karin A. M. Janssens
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE); University of Groningen; University Medical Center Groningen; The Netherlands
| | - Judith G. M. Rosmalen
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE); University of Groningen; University Medical Center Groningen; The Netherlands
| | - Albertine J. Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE); University of Groningen; University Medical Center Groningen; The Netherlands
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9
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Psychosomatic problems in relation to alcohol use and physical exercise: a study between 1988 and 2011 among adolescents in Sweden. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0729-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Mishra GD, Black S, Stafford M, Cooper R, Kuh D. Childhood and maternal effects on physical health related quality of life five decades later: the British 1946 birth cohort. PLoS One 2014; 9:e88524. [PMID: 24670776 PMCID: PMC3966737 DOI: 10.1371/journal.pone.0088524] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 01/07/2014] [Indexed: 12/15/2022] Open
Abstract
Limited research has been done on the relationships between childhood factors and adult physical health related quality of life, with the underlying pathways not fully elucidated. Data from 2292 participants of the British 1946 birth cohort were used to examine the relationship of childhood characteristics and family environment with principal component summary (PCS) scores and the physical functioning (PF) subscale of the SF-36 at age 60–64 years. Impaired physical functioning was defined as the lowest quartile scores in the PF subscale. Childhood factors (father in manual social class versus non-manual (β = −2.34; 95%CI: −3.39, −1.28) and poor maternal health versus good/excellent maternal health (β = −6.18; −8.78, −3.57)) were associated with lower PCS scores at 60–64 years. Adult health behaviours (increasing BMI, lifelong smoking, and lower physical activity) at 53 years were identified as strong risk factors for lower PCS scores. After adjusting for these factors and education level (N = 1463), only poor maternal health remained unattenuated (β = −5.07; −7.62, −2.51). Similarly poor maternal health doubled the risk of reporting impaired PF (Odds ratio = 2.45; 95%CI: 1.39, 4.30); serious illness in childhood (OR = 1.44; 1.01, 2.06) and lower educational level attained were also risk factors for impaired PF (N = 1526). While findings suggest the influence of father's social class on physical health related quality of life are mediated by modifiable adult social factors and health behaviours; health professionals should also be mindful of the inter-generational risk posed by poor maternal health on the physical health related quality of life of her offspring almost five decades later.
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Affiliation(s)
- Gita D. Mishra
- School of Population Health, University of Queensland, Brisbane, Australia
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
- * E-mail:
| | - Stephanie Black
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
| | - Mai Stafford
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
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Pelkonen ESJ, Mäki PH, Kyllönen MA, Miettunen JA, Taanila AM, Sipilä KK. Pain-related symptoms of temporomandibular disorders in the offspring of antenatally depressed mothers and depressed parents: a 31-year follow-up of the Northern Finland Birth Cohort 1966. Eur J Pain 2012; 17:1048-57. [PMID: 23255351 DOI: 10.1002/j.1532-2149.2012.00270.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2012] [Indexed: 01/04/2023]
Abstract
BACKGROUND Temporomandibular disorders (TMDs) are clinical problems involving the masticatory muscles and temporomandibular joints (TMJs). Aspects of the aetiology of TMD are controversial. Many studies have identified an association between depression and TMD. The aim of the study was to evaluate the association between both maternal antenatal depression and parental depression during the offspring's childhood with TMD symptoms of the offspring during adulthood and to evaluate the effect of the offspring's own depression on this association. METHODS In the general population-based Northern Finland Birth Cohort 1966 (NFBC 1966), mothers of 12,058 children were asked at mid-gestation at the antenatal clinic if they felt depressed. Of these offspring who had data available on TMD symptoms in the computer-aided inquiry at the 31-year field study, a final study data of 5541 subjects was compiled. The Finnish Hospital Discharge Register was used to identify depression in the parents between the years 1972 and 1984 (when offspring were 6-18 years old). RESULTS There were no statistically significant associations between TMD symptoms and maternal antenatal depressed mood. However, parental depression during the offspring's childhood associated significantly with facial pain [adjusted odds ratio (OR) = 1.64; 1.05-2.56] and with TMJ pain at jaw rest (OR = 1.81; 1.13-2.89), even after adjusting for gender, occupation of the father, family type at birth and the offspring's self-reported depression in adulthood. CONCLUSION The risk for TMD symptoms is not elevated in the offspring of antenatally depressed mothers. Parental depression during an offspring's childhood increases the risk of pain-related TMD symptoms in their early adulthood.
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Campo JV. Annual research review: functional somatic symptoms and associated anxiety and depression--developmental psychopathology in pediatric practice. J Child Psychol Psychiatry 2012; 53:575-92. [PMID: 22404290 DOI: 10.1111/j.1469-7610.2012.02535.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Medically unexplained physical symptoms, commonly referred to as functional somatic symptoms (FSS), are common in pediatric medical settings and associated with suffering, impairment, and medical help seeking. The association of pediatric FSS with anxiety and depressive symptoms and disorders across the life span is reviewed. METHOD Review and critique of controlled studies examining cross-sectional and longitudinal associations of FSS with anxiety and depressive symptoms and disorders in community-based and clinical samples of children and adolescents. RESULTS FSS are consistently associated cross-sectionally with anxiety and depressive symptoms and disorders in childhood and adolescence, and the likelihood of associated anxiety and depression increases with the number of reported FSS. The presence of one or more FSS early in life is associated with an increased likelihood of multiple FSS and anxiety and depressive symptoms and disorders later in life, and anxiety and depressive symptoms and disorders in childhood are associated with subsequent multiple FSS. CONCLUSION Strong associations between FSS, anxiety, and depression across the life span suggest the need to reconsider existing nosology and reconceptualize symptomatic relationships. Large, population-based longitudinal studies of FSS, anxiety, and depressive symptoms and disorders are needed to establish temporal relationships between the various symptoms and conditions.
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Affiliation(s)
- John V Campo
- Department of Psychiatry, Professor and chair, The Ohio State University, Columbus, Ohio, USA
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Psychiatric disorders in youth with medically unexplained chest pain versus innocent heart murmur. J Pediatr 2012; 160:320-4. [PMID: 21868030 PMCID: PMC3227786 DOI: 10.1016/j.jpeds.2011.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 05/27/2011] [Accepted: 07/11/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine the prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric disorders in youth with chest pain compared with a control sample with innocent heart murmur. STUDY DESIGN We assessed youth ages 8 to 17 years who were examined in cardiology settings for medically unexplained chest pain (n=100) or innocent heart murmur (n=80). We conducted semi-structured interviews and assessed medical history, quality of life, and disability. RESULTS Youth with chest pain had a higher prevalence of psychiatric disorders compared with youth with murmur (74% versus 47%, χ(2)=13.3; P<.001). Anxiety disorders predominated, although major depression was also more common in the chest pain group (9% versus 0%; Fisher exact tests; P<.01). Onset of psychiatric disorders generally preceded chest pain. Patterns were similar for boys and girls and for children and adolescents. Chest pain was associated with poorer quality of life and with pain-related disability for youth with co-morbid psychiatric disorder. CONCLUSIONS In childhood and adolescence, medically unexplained chest pain is associated with a high prevalence of psychiatric disorders. Systematic mental health screening may improve detection and enhance treatment of these patients.
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Chronic somatic complaints in adolescents: prevalence, predictive validity of the parent reports, and associations with social class, health status, and psychosocial distress. Soc Psychiatry Psychiatr Epidemiol 2011; 46:1003-11. [PMID: 20644908 DOI: 10.1007/s00127-010-0273-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 07/06/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE Chronic somatic complaint (CSC) can cause significant impairment of psychosocial functioning and therefore is of considerable interest in medicine, psychology, and related health sciences. To date, the type, distribution, and associated factors of CSC have been examined in only a limited number of studies. Main research questions of this investigation focused on the prevalence of CSC, the predictive validity of parent reports, and the associations with social class, health status, and psychosocial distress. METHODS Data were obtained from a population-based, German-wide representative Health Survey (N = 1,027 self-reports, and parent reports from 11- to 18-year-olds). In addition to study-specific items, the standardized Giessen Physical Complaints Inventory for Children and Adolescents was used (GPCI). RESULTS The most frequent CSCs in self-report forms were skin impurities/pimples, cold hands, and fatigue; older adolescents, especially females, were at a higher risk for CSC. The sensitivity of parent reports in all complaints observed was very low (Med = 0.21) and specificity varied between 0.94 and 1.00. Parents significantly underestimated CSC that were not externally observable, as well as CSC in males. Across different predictors and CSC dimensions, psychosocial distress showed the highest predictive value. CONCLUSIONS The results provide data regarding the subjective physical health of adolescents, as well as an empirical reference to evaluate the distribution of chronic symptoms in specific clinical populations (which is needed for prevention and treatment).
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Ball HA, Siribaddana SH, Sumathipala A, Kovas Y, Glozier N, Rijsdijk F, McGuffin P, Hotopf M. Genetic and environmental contributions to the overlap between psychological, fatigue and somatic symptoms: a twin study in Sri Lanka. Twin Res Hum Genet 2011; 14:53-63. [PMID: 21314256 PMCID: PMC3066854 DOI: 10.1375/twin.14.1.53] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Somatic symptoms often co-occur with psychological symptoms but this overlap is poorly understood. Some aspects of this overlap differ in the South Asian context, but it is not clear whether this is a reporting effect or an underlying difference in experienced illness. METHODS Home interviews were administered to 4,024 twins randomly selected from a population-based twin register in the Colombo district of Sri Lanka (the CoTASS study). These included assessments of psychological, somatic and fatigue symptoms. The data were analyzed using factor analytic and quantitative genetic approaches. RESULTS Confirmatory factor analysis showed that the symptoms from the three scales represented three separate dimensions, rather than all tapping into a single dimension. However, familial correlations among the data were most consistent with a common pathway model. This implies that a portion of the underlying vulnerability is common across psychological, fatigue and somatic symptoms. There were sex differences in the etiology of this model, with shared environmental and genetic influences playing different roles in men and women. CONCLUSIONS There is a complex etiological relationship between psychological, fatigue and somatic symptoms. This is similar in Sri Lanka to Western countries, but there may be a greater influence from the family environment, suggesting that care needs to be taken when generalizing research findings between countries. People who complain of certain fatigue or somatic symptoms may well also have psychological symptoms, or may have genetic or environmental vulnerabilities to such problems.
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Affiliation(s)
- Harriet A Ball
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, United Kingdom.
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Dunn KM. Extending conceptual frameworks: life course epidemiology for the study of back pain. BMC Musculoskelet Disord 2010; 11:23. [PMID: 20122264 PMCID: PMC2829505 DOI: 10.1186/1471-2474-11-23] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Accepted: 02/02/2010] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Epidemiological studies have identified important causal and prognostic factors for back pain, but these frequently only identify a proportion of the variance, and new factors add little to these models. Recently, interest has increased in studying diseases over the life course, stimulated by the 1997 book by Kuh and Ben-Shlomo, a move accompanied by important conceptual and methodological developments. This has resulted in improvements in the understanding of other conditions like cardiovascular and respiratory disease. This paper aims to examine how conceptual frameworks from life course epidemiology could enhance back pain research. DISCUSSION Life course concepts can be divided into three categories. Concept 1: patterns over time, risk chains and accumulation. Simple 'chains of risk' have been studied - e.g. depression leading to back pain - but studies involving more risk factors in the chain are infrequent. Also, we have not examined how risk accumulation influences outcome, e.g. whether multiple episodes or duration of depression, throughout the life course, better predicts back pain. One-year back pain trajectories have been described, and show advantages for studying back pain, but there are few descriptions of longer-term patterns with associated transitions and turning points. Concept 2: influences and determinants of pathways. Analyses in back pain studies commonly adjust associations for potential confounders, but specific analysis of factors modifying risk, or related to the resilience or susceptibility to back pain, are rarely studied. Concept 3: timing of risk. Studies of critical or sensitive periods - crucial times of life which influence health later in life - are scarce in back pain research. Such analyses could help identify factors that influence the experience of pain throughout the life course. SUMMARY Back pain researchers could usefully develop hypotheses and models of how risks from different stages of life might interact and influence the onset, persistence and prognosis of back pain throughout the life course. Adoption of concepts and methods from life course epidemiology could facilitate this.
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Von Korff M, Alonso J, Ormel J, Angermeyer M, Bruffaerts R, Fleiz C, de Girolamo G, Kessler RC, Kovess-Masfety V, Posada-Villa J, Scott KM, Uda H. Childhood psychosocial stressors and adult onset arthritis: broad spectrum risk factors and allostatic load. Pain 2009; 143:76-83. [PMID: 19251363 PMCID: PMC2703588 DOI: 10.1016/j.pain.2009.01.034] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2008] [Revised: 01/08/2009] [Accepted: 01/30/2009] [Indexed: 10/21/2022]
Abstract
Neural, endocrine, and immune stress mediators are hypothesized to increase risks of diverse chronic diseases, including arthritis. Retrospective data from the World Mental Health Surveys (N=18,309) were employed to assess whether adult onset of arthritis was associated with childhood adversities and early onset psychological disorder. Cox proportional hazard models assessed the association of number of childhood adversities and the presence of early onset psychological disorder with arthritis age of onset. Controlling for age, sex, and early onset mental disorder, relative to persons with no childhood adversities, persons with two adversities had an increased risk of adult onset arthritis (hazard ratio=1.27, 95% CI=1.08, 1.50), while persons with three or more adversities had a higher risk (HR=1.44, CI=1.24, 1.67). Early onset depressive and/or anxiety disorder was associated with an increased risk of adult onset arthritis after controlling for childhood adversities (HR=1.43, CI=1.28, 1.61). Since psychosocial stressors may be broad spectrum risk factors that increase risks of diverse chronic conditions in later life (e.g. arthritis, heart disease, diabetes, asthma, and chronic pain), prospective studies of childhood psychosocial stressors may be most productive if multiple disease outcomes are assessed in the same study. Results from this study provide methodological guidance for future prospective studies of the relationship between childhood psychosocial stressors and subsequent risk of adult onset arthritis.
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Affiliation(s)
- Michael Von Korff
- Group Health Center for Health Studies; 1730 Minor Avenue, Suite 1600, Seattle WA 98101 USA, , 206-287-2874 (ph), 206-287-2871 (Fax)
| | - Jordi Alonso
- Health Services Research Unit Institut Municipal d’Investigacio Medica (IMIM), CIBER en Epidemiologia y Salud Publica, (CIBERESP), Barcelona, Spain
| | - Johan Ormel
- Professor of Social Psychiatry and Psychiatric Epidemiology, University Medical Center Groningen, Netherlands,
| | | | - Ronny Bruffaerts
- Department of Neurosciences and Psychiatry, University Hospitals Gasthuisberg Leuven, Belgium
| | - Clara Fleiz
- National Instituto on Psychiatry Ramon de la Fuente, Mexico City, Mexico
| | | | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA,
| | - Viviane Kovess-Masfety
- Directrice Fondation MGEN pour la santé publique, Université Paris Descartes, Paris, France,
| | - José Posada-Villa
- Ministry of Social Protection, Colegio Mayor de Cundinamarca University, Bogota, Colombia,
| | - Kate M. Scott
- Department of Psychological Medicine; Otago University, Wellington; PO Box 7343, Wellington South, New Zealand,
| | - Hidenori Uda
- Director General, Social Welfare, and Environmental Department Osumi Regional Promotion Bureau, Kagoshima Prefecture, Japan,
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HOUTVEEN JANH, VAN DOORNEN LORENZJP. Negative affect and 24-hour ambulatory physiological recordings as predictors of spontaneous improvement of medically unexplained symptoms. Scand J Psychol 2008; 49:591-601. [DOI: 10.1111/j.1467-9450.2008.00684.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Eminson DM. Medically unexplained symptoms in children and adolescents. Clin Psychol Rev 2007; 27:855-71. [PMID: 17804131 DOI: 10.1016/j.cpr.2007.07.007] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2005] [Revised: 06/04/2006] [Accepted: 02/07/2007] [Indexed: 01/30/2023]
Abstract
A review is presented of the range of medically unexplained symptoms (MUS) in children and adolescents, with an account of the main presentations that are recognised in clinical settings in paediatric and children's mental health services. A summary of both epidemiological and clinical studies of symptoms and their associations is given, followed by a brief overview of aetiological theories and of management interventions.
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Affiliation(s)
- D Mary Eminson
- Bolton Hospitals NHS Trust, Child and Adolescent Mental Health Services, Royal Bolton Hospital, Minerva Road, Farnworth, Bolton BL4 OJR, UK.
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Salmon P. Conflict, collusion or collaboration in consultations about medically unexplained symptoms: the need for a curriculum of medical explanation. PATIENT EDUCATION AND COUNSELING 2007; 67:246-54. [PMID: 17428634 DOI: 10.1016/j.pec.2007.03.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Revised: 03/05/2007] [Accepted: 03/06/2007] [Indexed: 05/14/2023]
Abstract
OBJECTIVE To identify the basis of the communication problems that characterise consultations about medically unexplained symptoms (MUS) and to identify implications for clinical education. METHOD Recent research into the details of clinical communication about MUS was reviewed narratively and critically, and broader research literature was scrutinised from the perspective of a practitioner who wishes to provide patients with explanations for such symptoms. RESULTS Consultations about MUS often involve contest between patients' authority, resting on their knowledge of their symptoms, and practitioners' authority, based on the normal findings of tests and investigations. The outcome of consultations can therefore depend on the strategies that each party uses to press their authority, rather than on clinical need. CONCLUSION Contest is a product of patients and practitioners occupying separate conceptual 'ground'. Avoiding contest requires the practitioner to find common conceptual ground within which each party can understand and discuss the symptoms. Finding common ground by collusion with explanations that patients suggest can damage clinical relationships. Instead the practitioner needs to fashion explanation that is acceptable to both parties from available medical and lay material. PRACTICE IMPLICATIONS Although practitioners commonly fashion such explanations, this aspect of their professional role seems not to be greatly valued amongst practitioners or in medical curricula. Clinical education programmes could include curricula in symptom explanation, drawing from research in medicine, psychology and anthropology.
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Affiliation(s)
- Peter Salmon
- Division of Clinical Psychology, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB, UK.
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Houtveen JH, Oei NYL. Recall bias in reporting medically unexplained symptoms comes from semantic memory. J Psychosom Res 2007; 62:277-82. [PMID: 17324676 DOI: 10.1016/j.jpsychores.2006.11.006] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2006] [Revised: 11/02/2006] [Accepted: 11/14/2006] [Indexed: 11/20/2022]
Abstract
OBJECTIVE When people report somatic complaints retrospectively, they depend on their memory. Therefore, retrospective reports can be influenced by general beliefs on sickness and health from semantic memory. We hypothesized that individuals with medically unexplained symptoms (MUS) would have recall biases stronger than those of people without complaints when reporting symptoms retrospectively, and that this effect would be a function of time between symptom experience and report. METHODS To compare two time frames, 37 participants who were high and low on MUS reported momentary symptoms combined by daily recall and weekly recall using an electronic diary. RESULTS Both groups reported more symptoms when recalling the entire week than what could be expected from average momentary reports. However, participants high on MUS also reported more symptoms when recalling a week than when recalling a day. For this group, recall bias was not associated with peak heuristic or symptoms variability. CONCLUSION Symptom reports in people high on MUS increases as time passes by, probably as a results of a shift in memory retrieval strategy from using episodic knowledge to using semantic beliefs.
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Affiliation(s)
- Jan H Houtveen
- Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
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Course and predictors of medically unexplained pain symptoms in the general population. J Psychosom Res 2007; 62:119-28. [PMID: 17270569 DOI: 10.1016/j.jpsychores.2006.08.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 08/07/2006] [Accepted: 08/24/2006] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The objective of this study was to explore the course and the predictors of clinically significant medically unexplained pain symptoms (MUS-pain) within the 6 months preceding the interviews at baseline and on follow-up in the general population. METHODS A Norwegian general population study of 605 persons interviewed with the Composite International Diagnostic Interview Somatoform Section was conducted in 1989/1990 (baseline), and 421 persons (69.6% response rate; 242 women and 179 men) were reinterviewed in 2000/2001 (follow-up). Cases of recent MUS-pain compared with those at baseline were assessed on follow-up. Four blockwise logistic regression analyses were undertaken to find predictors (such as stressful life events, living alone, depression and anxiety, and physical morbidity) for recent MUS-pain in 2001. RESULTS A small "stable" group of recent MUS-pain sufferers (8% of all reinterviewed and 33.6% of those with recent MUS-pain at baseline) was evident. In this group almost all were women. In addition to female gender being a significant (P<.05) marker of recent MUS-pain (which gives a twofold-higher risk compared with men), only depression--not the occurrence of prior recent MUS-pain--remained a significant (P<.05) predictor in the final model, increasing the likelihood of having recent MUS-pain by threefold. CONCLUSION The prognosis of MUS-pain is relatively good, except for a small group (mainly women) that is prone to chronicity. Clinicians should examine for depression when confronted with MUS-pain patients and should be aware of the twofold-higher risk in women for persistent MUS-pain over a long time.
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Hiller W, Rief W, Brähler E. Somatization in the population: from mild bodily misperceptions to disabling symptoms. Soc Psychiatry Psychiatr Epidemiol 2006; 41:704-12. [PMID: 16794766 DOI: 10.1007/s00127-006-0082-y] [Citation(s) in RCA: 161] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2006] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study investigates the prevalence of current somatization in the population by taking different levels of symptom severity into account. Somatization is described along a continuum from mild and negligible bodily misperceptions to severe and disabling somatoform symptoms. METHODS A representative sample of 2.552 persons in Germany was examined with a screening instrument for medically unexplained physical complaints that had occurred during the past 7 days. All 53 symptoms from the ICD-10/DSM-IV sections of somatoform disorders were included. RESULTS 81.6% reported at least one symptom causing at least mild impairment and 22.1% at least one symptom causing severe impairment. The entire sample had an average of 6.6 symptoms associated with at least mild distress. Somatization of any degree was associated with female gender, age above 45, lower educational level, lower household income and rural area. The most common symptoms with prevalence rates > 20% were various types of pain (back, head, joints, extremities), food intolerance, sexual indifference, painful menstruations and erectile/ejaculatory dysfunction. CONCLUSION This population survey demonstrates that medically unclear complaints are an everyday phenomenon. About three out of four cases are below clinical relevance with only low level of impairment. Epidemiological correlates are similar between clinical and non-clinical forms of somatization.
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Affiliation(s)
- Wolfgang Hiller
- Department of Clinical Psychology, University of Mainz, Staudingerweg 9, 55099 Mainz, Germany.
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Illness Behavior and Functional Somatic Symptoms – Rethinking the Concept of Illness Behavior from an Anthropological Perspective. SOCIAL THEORY & HEALTH 2006. [DOI: 10.1057/palgrave.sth.8700070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ursin H. Press stop to start: the role of inhibition for choice and health. Psychoneuroendocrinology 2005; 30:1059-65. [PMID: 15964145 DOI: 10.1016/j.psyneuen.2005.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Revised: 02/14/2005] [Accepted: 03/31/2005] [Indexed: 11/23/2022]
Abstract
In order to react adequately to any new challenge, it is necessary to stop all ongoing activity. The first phase in the orienting response to a novel stimulus is an arrest of all ongoing activity. Inhibition is also necessary to switch from one behaviour to another, and from one cognitive activity to another. Inhibition was a difficult phenomenon to handle until the role of inhibitory synapses was demonstrated, and that many brain areas have an inhibitory function for overt behaviour and for establishing new responses in learning experiments. The role of these areas for learning and for plasticity of the brain has been well established. Recently, the role of inhibition, or lack of inhibition, for cognitive activities has been discussed for the understanding of somatization and sensitization to afferent somatic impulses. It has been postulated that muscle pain is maintained by positive feed back loops between muscles, the spinal cord, and the brain areas for pain and interpretation of pain. Activity in these loops may lead to sensitisation of the neural circuits, leading to chronic pain states. Similar models have been presented for non-specific gastric and intestinal complaints, and for fatigue and depression. Rumination and perseveration of negative thoughts may maintain the activity in these loops.
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Affiliation(s)
- Holger Ursin
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
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Terre L, Carlos Poston WS, Foreyt J, Jeor STS, Horrigan KL. Does family of origin functioning predict adult somatic complaints? Psychol Health 2004. [DOI: 10.1080/0887044042000196683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Lester P, Stein JA, Bursch B. Developmental predictors of somatic symptoms in adolescents of parents with HIV: a 12-month follow-up. J Dev Behav Pediatr 2003; 24:242-50. [PMID: 12915796 DOI: 10.1097/00004703-200308000-00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Adolescents of parents with HIV provide a test for proposed risk factors for somatic symptoms. This study prospectively examined family and developmental predictors of somatic symptoms in a high-risk community sample. A longitudinal latent variable model predicted adolescent somatization scores from the Brief Symptom Inventory 12 months after baseline assessment of 211 parent-adolescent pairs. In this cohort, somatic symptoms during adolescence persisted over time (p <.001) and were predicted by female gender (p <.05). In addition, (1). parental distress over pain predicted adolescent somatic symptoms at baseline and follow-up (p <.001), (2). adolescents who experienced their parents as highly rejecting reported more somatic symptoms at follow-up (p <.001), and (3). school problems correlated with somatic symptoms (p <.001), as well as parental rejection (p <.001), at baseline. These findings underscore potential relationships among parental illness, parent-child relationships, and somatic distress. Adolescents with school problems are particularly vulnerable, at least in the short run. These data support a family-based approach to treatment programs for adolescents with increased levels of somatic distress.
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Affiliation(s)
- Patricia Lester
- Center for Community, Department of Psychiatry, University of California, Los Angeles, CA 90024, USA.
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