Prognostic significance of functional somatic symptoms in adolescence: a 15-year community-based follow-up study of adolescents with depression compared with healthy peers
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BACKGROUND: There is a lack of population-based long-term longitudinal research on mental health status and functional physical/somatic symptoms. Little is known about the long-term mental health outcomes associated with somatic symptoms or the temporal relationship between depression and such symptoms. This 15-year study followed up adolescents with depression and matched controls, screened from a population-based sample, who reported different numbers of somatic symptoms. METHODS: The total population of 16-17-year-olds in Uppsala, Sweden, was screened for depression in 1991-1993. Adolescents who screened positive and an equal number of healthy controls took part in a semi-structured diagnostic interview. In addition, 21 different self-rated somatic symptoms were assessed. Sixty-four percent of those adolescents participated in a follow-up structured interview 15 years later. RESULTS: Somatic symptoms in adolescence predicted depression and other adult mental disorders regardless of the presence of adolescent depression. In adolescents with depression, the number of functional somatic symptoms predicted, in a dose response relationship, suicidal behavior, bipolar episodes, and psychotic episodes as well as chronic and recurrent depression. Contrary to expectations, the somatic symptoms of abdominal pain and perspiration without exertion better predicted depression than all DSM-IV depressive symptoms. Abdominal pain persisted as an independent strong predictor of depression and anxiety, even after controlling for other important confounders. CONCLUSIONS: Somatic symptoms in adolescence can predict severe adult mental health disorders. The number of somatic symptoms concurrent with adolescent depression is, in a stepwise manner, linked to suicidal attempts, bipolar disorders, psychotic disorders, and recurrent and chronic depression. These findings can be useful in developing treatment guidelines for patients with somatic symptoms.
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FSS symptoms frequently sustain into adulthood, carrying a significant risk of long-term impairment, reduced probability of obtaining higher education and high use of health care costs.
“Frequently, symptoms sustain into adulthood, carrying a significant risk of long-term impairment, reduced probability of obtaining a higher education and a high use of health care costs [9–13].”
From Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: A pilot study (2020) · cites this paper as [13]
The Discussion (page unavailable) links adolescent somatic symptoms to adverse adult mental-health outcomes, supporting the long-term impairment point; it does not establish that the somatic symptoms themselves persist. The Background (page unavailable) reports higher health-care utilization, but not costs. The paper does not report a reduced probability of obtaining higher education. (LLM, conf=0.88)
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- Authors
- Bohman, H., Jonsson, U., Päären, A., von Knorring, L., Olsson, G., & von Knorring, A.-L.
- Affiliations
- Uppsala University (SE)
- Corresponding author
- Bohman, Hannes
- ORCID
- Bohman, Hannes
- Venue
- BMC Psychiatry
- Published
- 2012-07-27
- Volume
- 12
- Issue
- 1
- Pages
- 90-90
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC3439696
- OpenAlex
- W2122939734
- Cited by
- 126
- References
- 42
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 7 · 2020: 10 · 2019: 8 · 2018: 12 · 2017: 4 · 2016: 14 · 2015: 5 · 2014: 17 · 2013: 5 · 2012: 1
- FWCI
- 6.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Forskningsrådet för Arbetsliv och Socialvetenskap
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- functional somatic symptoms, adolescent depression, long-term mental health outcomes, abdominal pain, suicidal behavior, bipolar disorder, psychosis, chronic depression, anxiety, dose-response relationship, prognostic factors, community-based follow-up
- MeSH terms
- Adolescent, Adult, Bipolar Disorder, Depression, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Mental Health, Predictive Value of Tests, Prognosis, Psychotic Disorders, Recurrence, Suicide, Attempted, Sweating, Abdominal Pain
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