Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-16T20:19:50.023Z Has data issue: false hasContentIssue false
  • English
  • Français

Childhood somatic complaints predict generalized anxiety and depressive disorders during young adulthood in a community sample

Published online by Cambridge University Press:  18 December 2014

L. Shanahan ,
N. Zucker ,
W. E. Copeland ,
C. L. Bondy ,
H. L. Egger  and
E. J. Costello
L. Shanahan*
Affiliation:
Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
N. Zucker
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
W. E. Copeland
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA Duke Center for Eating Disorders, Durham, NC, USA
C. L. Bondy
Affiliation:
Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
H. L. Egger
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
E. J. Costello
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
*
*Address for correspondence: L. Shanahan, Ph.D., Department of Psychology, University of North Carolina at Chapel Hill, CB #3270, Davie Hall, Chapel Hill, NC, 27599-3270, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Children with somatic complaints are at increased risk for emotional disorders during childhood. Whether this elevated risk extends into young adulthood – and to which specific disorders – has rarely been tested with long-term prospective-longitudinal community samples. Here we test whether frequent and recurring stomach aches, headaches, and muscle aches during childhood predict emotional disorders in adulthood after accounting for childhood psychiatric and physical health status and psychosocial adversity.

Method

The Great Smoky Mountains Study is a community representative sample with 1420 participants. Children/adolescents were assessed 4–7 times between ages 9–16 years. They were assessed again up to three times between ages 19–26 years. Childhood somatic complaints were coded when subjects or their parents reported frequent and recurrent headaches, stomach aches, or muscular/joint aches at some point when children were aged 9–16 years. Psychiatric disorders were assessed with the Child and Adolescent Psychiatric Assessment and the Young Adult Psychiatric Assessment.

Results

Frequent and recurrent somatic complaints in childhood predicted adulthood emotional disorders. After controlling for potential confounders, predictions from childhood somatic complaints were specific to later depression and generalized anxiety disorder. Long-term predictions did not differ by sex. Somatic complaints that persisted across developmental periods were associated with the highest risk for young adult emotional distress disorders.

Conclusions

Children from the community with frequent and recurrent physical distress are at substantially increased risk for emotional distress disorders during young adulthood. Preventions and interventions for somatic complaints could help alleviate this risk.

Keywords

Depressiongeneralized anxietyheadachessomatic complaintsstomach aches
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 8 , June 2015 , pp. 1721 - 1730
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition Text Revision. American Psychiatric Press: Washington, DC.Google Scholar
Angold, A, Costello, EJ (1995). A test-retest reliability study of child-reported psychiatric symptoms and diagnoses using the Child and Adolescent Psychiatric Assessment (CAPA-C). Psychological Medicine 25, 755–762.CrossRefGoogle ScholarPubMed
Angold, A, Costello, EJ (2000). The Child and Adolescent Psychiatric Assessment (CAPA). Journal of the American Academy of Child and Adolescent Psychiatry 39, 39–48.CrossRefGoogle ScholarPubMed
Angold, A, Costello, EJ, Worthman, CM (1999 a). Pubertal changes in hormone levels and depression in girls. Psychological Medicine 29, 1043–1053.Google Scholar
Angold, A, Cox, A, Prendergast, M, Rutter, M, Simonoff, E, Costello, EJ, Ascher, BH (1999 b). The Young Adult Psychiatric Assessment (YAPA). Duke University Medical Center: Durham, NC.Google Scholar
Angold, A, Prendergast, M, Cox, A, Harrington, R, Simonoff, E, Rutter, M (1995). The Child and Adolescent Psychiatric Assessment (CAPA). Psychological Medicine 25, 739–753.CrossRefGoogle ScholarPubMed
Ascher, BH, Farmer, EMZ, Burns, BJ, Angold, A (1996). The Child and Adolescent Services Assessment (CASA): description and psychometrics. Journal of Emotional and Behavioral Disorders 4, 12–20.CrossRefGoogle Scholar
Beck, JE, Lipani, TA, Baber, KF, Dufton, L, Garber, J, Smith, CA, Walker, LS (2011). Attentional bias to pain and social threat in pediatric patients with functional abdominal pain and pain-free youth before and after performance evaluation. Pain 152, 1061–1067.Google Scholar
Campo, JV, Di Lorenzo, C, Chiappetta, L, Bridge, J, Colborn, DK, Gartner, JCJ, Gaffney, P, Kocoshis, S, Brent, D (2001). Adult outcomes of pediatric recurrent abdominal pain: do they just grow out of it? Pediatrics 108, E1.Google Scholar
Campo, JV, Fritsch, SL (1994). Somatization in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 33, 1223–1235.Google Scholar
Clark, LA, Watson, D (2006). Distress and fear disorders: an alternative empirically based taxonomy of the ‘mood’ and ‘anxiety’ disorders. British Journal of Psychiatry 189, 481–483.Google Scholar
Collins, PY, Patel, V, Joestl, SS, March, D, Insel, TR, Daar, AS, Scientific Advisory Board and the Executive Committee of the Grand Challenges on Global Mental Health (2011). Grand challenges in global mental health. Nature 475, 27–30.Google Scholar
Copeland, WE, Angold, A, Shanahan, L, Costello, EJ (2014). Longitudinal patterns of anxiety from childhood to adulthood: The Great Smoky Mountains Study. Journal of the American Academy of Child and Adolescent Psychiatry 53, 21–33.CrossRefGoogle ScholarPubMed
Copeland, WE, Shanahan, L, Costello, EJ, Angold, A (2009). Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Archives of General Psychiatry 66, 764–772.Google Scholar
Copeland, WE, Wolke, D, Angold, A, Costello, EJ (2013). Adult psychiatric outcomes of bullying and being bullied by peers in childhood and adolescence. Journal of the American Medical Association: Psychiatry 70, 419–426.Google ScholarPubMed
Costello, EJ, Angold, A, Burns, BJ, Stangl, DK, Tweed, DL, Erkanli, A, Worthman, CM (1996). The Great Smoky Mountains Study of Youth: goals, designs, methods, and the prevalence of DSM-III-R disorders. Archives of General Psychiatry 53, 1129–1136.CrossRefGoogle ScholarPubMed
Costello, EJ, Compton, SN, Keeler, G, Angold, A (2003). Relationships between poverty and psychopathology: a natural experiment. Journal of the American Medical Association 290, 2023–2029.Google Scholar
Costello, EJ, He, JP, Sampson, NA, Kessler, RC, Merikangas, KR (2014). Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey – Adolescent Supplement. Psychiatric Services 65, 359–366.Google Scholar
Dantzer, R, O'Connor, JC, Freund, GG, Johnson, RW, Kelley, KW (2008). From inflammation to sickness and depression: when the immune system subjugates the brain. Nature Reviews Neuroscience 9, 46–56.Google Scholar
Dimsdale, JE, Dantzer, R (2007). A biological substrate for somatoform disorders: importance of pathophysiology. Psychosomatic Medicine 69, 850–854.CrossRefGoogle ScholarPubMed
Dinan, TG, Cryan, JF (2012). Regulation of the stress response by the gut microbiota: implications for Psychoneuroendocrinology. Psychoneuroendocrinology 37, 1369–1378.Google Scholar
Dufton, LM, Dunn, MJ, Compas, BE (2009). Anxiety and somatic complaints in children with recurrent abdominal pain and anxiety disorders. Journal of Pediatric Psychology 34, 176–186.Google Scholar
Dunn, KM, Jordan, KP, Mancl, L, Drangsholt, MT, Le Resche, L (2011). Trajectories of pain in adolescents: a prospective cohort study. Pain 152, 66–73.Google Scholar
Egger, HL, Angold, A, Costello, EJ (1998). Headaches and psychopathology in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 37, 951–958.Google Scholar
Egger, HL, Angold, A, Costello, EJ (1999). Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains and headaches. Journal of the American Academy of Child and Adolescent Psychiatry 38, 852–860.Google Scholar
Farmer, E, Burns, B, Phillips, S, Angold, A, Costello, EJ (2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services 54, 60–66.CrossRefGoogle ScholarPubMed
Fearon, P, Hotopf, M (2001). Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study. British Medical Journal 322, 1145.Google Scholar
Garber, J, Walker, LS, Zeman, J (1991). Somatization symptoms in a community sample of children and adolescents: further validation of the children's somatization inventory. Psychological Assessment 3, 588–595.CrossRefGoogle Scholar
Garralda, ME (2011). Unexplained physical complaints. Pediatric Clinics of North America 58, 803–813.Google Scholar
Green, JG, McLaughlin, KA, Alegría, M, Costello, EJ, Gruber, MJ, Hoagwood, K, Leaf, PJ, Olin, S, Sampson, NA, Kessler, RC (2013). School mental health resources and adolescent mental health service use. Journal of the American Academy of Child & Adolescent Psychiatry 52, 501–510.Google Scholar
Hoftun, GB, Romundstad, PR, Rygg, M (2013). Association of parental chronic pain with chronic pain in the adolescent and young adult: family linkage data from the HUNT Study. Journal of the American Medical Association: Pediatrics 167, 61–69.Google Scholar
Hotopf, M, Carr, S, Mayou, R, Wadsworth, M, Wessely, S (1998). Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. British Medical Journal 316, 1196–1200.Google Scholar
Hyams, JS, Hyman, PE (1998). Recurrent abdominal pain and the biopsychosocial model of medical practice. Journal of Pediatrics 133, 473–478.Google Scholar
Kalaydjian, A, Merikangas, K (2008). Physical and mental comorbidity of headache in a nationally representative sample of US adults. Psychosomatic Medicine 70, 773–780.Google Scholar
Lahey, B, Rathouz, P, Van Hulle, C, Urbano, R, Krueger, R, Applegate, B, Garriock, H, Chapman, D, Waldman, I (2008). Testing structural models of DSM-IV symptoms of common forms of child and adolescent psychopathology. Journal of Abnormal Child Psychology 36, 187–206.CrossRefGoogle ScholarPubMed
Luntamo, T, Sourander, A, Gyllenberg, D, Sillanmäki, L, Aromaa, M, Tamminen, T, Kumpulainen, K, Moilanen, I, Piha, J (2014). Do headache and abdominal pain in childhood predict suicides and severe suicide attempts? Finnish nationwide 1981 birth cohort study. Child Psychiatry & Human Development 45, 110–118.Google Scholar
Luntamo, T, Sourander, A, Sillanmäki, L, Gyllenberg, D, Aromaa, M, Kumpulainen, K, Moilanen, I, Almqvist, F, Tamminen, T, Piha, J (2012). Pain at age eight as a predictor of antidepressant medication use by age 24: findings from the Finnish nationwide 1981 birth cohort study. Journal of Affective Disorders 138, 153–159.Google Scholar
National Center for Health Statistics (1988). Child Health Supplement. In Current Estimates from the National Health Interview Survey (ed. Adams, P. and Hardy, A.), Hyattsville, MD.Google Scholar
Raison, CL, Capuron, L, Miller, AH (2006). Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends in Immunology 27, 24–31.CrossRefGoogle ScholarPubMed
Ramchandani, PG, Fazel, M, Stein, A, Wiles, N, Hotopf, M (2007). The impact of recurrent abdominal pain: predictors of outcome in a large population cohort. Acta Paediatrica 96, 697–701.CrossRefGoogle Scholar
Rief, W, Hennings, A, Riemer, S, Euteneuer, F (2010). Psychobiological differences between depression and somatization. Journal of Psychosomatic Research 68, 495–502.CrossRefGoogle ScholarPubMed
Rohde, P, Lewinsohn, PM, Klein, DN, Seeley, JR, Gau, JM (2013). Key characteristics of Major Depressive Disorder occurring in childhood, adolescence, emerging adulthood, and adulthood. Clinical Psychological Science 1, 41–53.Google Scholar
Saps, M, Seshadri, R, Sztainberg, M, Schaffer, G, Marshall, BM, Di Lorenzo, C (2009). A prospective school-based study of abdominal pain and other common somatic complaints in children. Journal of Pediatrics 154, 322–326.Google Scholar
SAS Institute Inc (2008). SAS/STAT® Software: Version 9.2. SAS Institute, Inc.: Cary, NC.Google Scholar
Shelby, GD, Shirkey, KC, Sherman, AL, Beck, JE, Haman, K, Shears, AR, Horst, SN, Smith, CA, Garber, J, Walker, LS (2013). Functional abdominal pain in childhood and long-term vulnerability to anxiety disorders. Pediatrics 132, 475–482.Google Scholar
Stanford, EA, Chambers, CT, Biesanz, JC, Chen, E (2008). The frequency, trajectories and predictors of adolescent recurrent pain: a population-based approach. Pain 138, 11–21.Google Scholar
Walker, LS, Claar, RL, Garber, J (2002). Social consequences of children's pain: when do they encourage symptom maintenance? Journal of Pediatric Psychology 27, 689–698.CrossRefGoogle ScholarPubMed
Walker, LS, Garber, J, Greene, JW (1993). Psychosocial correlates of recurrent childhood pain: a comparison of pediatric patients with recurrent abdominal pain, organic illness, and psychiatric disorders. Journal of Abnormal Psychology 102, 248–258.Google Scholar
Walker, LS, Garber, J, Smith, CA, Van Slyke, DA, Claar, RL (2001). The relation of daily stressors to somatic and emotional symptoms in children with and without recurrent abdominal pain. Journal of Consulting and Clinical Psychology 69, 85–91.Google Scholar
Weersing, VR, Rozenman, MS, Maher-Bridge, M, Campo, JV (2012). Anxiety, depression, and somatic distress: developing a transdiagnostic internalizing toolbox for pediatric practice. Cognitive and Behavioral Practice 19, 68–82.Google Scholar
Supplementary material: File

Shanahan Supplementary Material

Supplementary Material 1

Download Shanahan Supplementary Material(File)
File 56.3 KB
Supplementary material: File

Shanahan Supplementary Material

Supplementary Material 2

Download Shanahan Supplementary Material(File)
File 16.2 KB
Supplementary material: File

Shanahan Supplementary Material

Supplementary Material 3

Download Shanahan Supplementary Material(File)
File 22.4 KB