Anxiety and depression are risk factors rather than consequences of functional somatic symptoms in a general population of adolescents: the TRAILS study
Abstract
BACKGROUND: It is well known that functional somatic symptoms (FSS) are associated with anxiety and depression. However, evidence is lacking about how they are related to FSS. The aim of this study was to clarify these relationships and examine whether anxiety and depression are distinctly related to FSS. We hypothesized that anxiety contributes to the development of FSS and that depression is a consequence of FSS. METHODS: FSS, anxiety, and depression were measured in adolescents (N = 2230, 51% women) by subscales of the Youth Self-Report during three assessment waves (adolescents successively aged: 10-12, 12-14, and 14-17) and by corresponding subscales of the Child Behavior Checklist. Using structural equation models, we combined trait and state models of FSS with those of anxiety and depression, respectively. We identified which relationships (contemporaneous and two-year lagged) significantly connected the states of FSS with the states of anxiety and depression. RESULTS: Trait variables were all highly interrelated (r = .54-.63). Contrary to our hypothesis, both state anxiety (beta = .35) and state depression (beta = .45) had a strong contemporaneous effect on state FSS. In turn, state FSS had a weak two-year lagged effect on state anxiety (beta = .11) and an even weaker effect on state depression (beta = .06). CONCLUSIONS: While the effect of anxiety and depression on FSS is strong and immediate, FSS exert a weaker and delayed influence on anxiety and depression. Further research should be done to detect the exact ways in which anxiety and depression lead to FSS, and FSS lead to anxiety and depression.
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High-state anxiety and depression can induce physiological changes, an intensified attention to the body and an alteration of the cognitive processing of physical sensations, representing important precipitating factors.
“This might due to the fact that high-state anxiety and depression can induce physiological changes, an intensified attention to the body and an alteration of the cognitive processing of physical sensations, representing important precipitating factors (Mayou and Farmer, 2002; Janssens et al., 2010; Mallorquí-bagué et al., 2016).”
From Does the practice of mindfulness reduce somatic symptoms and COVID-19-related anxiety? A community-based survey (2022) · cites this paper as Janssens et al., 2010
Research has shown that somatic symptoms are associated with at least a 2-fold increase in the likelihood of having a depressive and/or anxiety disorder.
“research has shown that they are associated with at least a 2-fold increase in the likelihood of having a depressive and/or anxiety disorder (Kroenke et al., 1997; Janssens et al., 2010; van Boven et al., 2011; Groen et al., 2021).”
From Does the practice of mindfulness reduce somatic symptoms and COVID-19-related anxiety? A community-based survey (2022) · cites this paper as Janssens et al., 2010
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- Authors
- Janssens, K. A. M., Rosmalen, J. G. M., Ormel, J., Van Oort, F. V. A., & Oldehinkel, A. J.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Janssens, Karin A.M.
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2010-02
- Volume
- 51
- Issue
- 3
- Pages
- 304-312
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2020684380
- Cited by
- 107
- References
- 34
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 11 · 2022: 8 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 6 · 2017: 9 · 2016: 6 · 2015: 7 · 2014: 12 · 2013: 6 · 2012: 6
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Rijksuniversiteit Groningen
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- functional somatic symptoms, anxiety, depression, adolescents, risk factors, bidirectional relationship, state anxiety, depressive state, trait anxiety, Youth Self-Report, Child Behavior Checklist, TRAILS study
- MeSH terms
- Adolescent, Adolescent Behavior, Anxiety, Child, Depression, Female, Humans, Male, Netherlands, Prospective Studies, Risk Factors, Somatoform Disorders
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