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Somatic symptoms as a marker for severity in adolescent depression
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
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2010 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 11, 1724-1730 p.Article in journal (Refereed) Published
Abstract [en]

Aim: This study aims to investigate the prevalence of somatic symptoms in depressed adolescents and in their healthy peers. A second aim is to investigate the correlation, in the depressed adolescents, between the number of somatic symptoms and severe concurrent symptoms, signs and life events. Methods: The total population of 16-17 year olds - in the city of Uppsala - was screened for depression and then interviewed using a structured interview questionnaire. Depressed subjects and matched controls were identified. A total of 177 pairs were used for pair-wise analyses of somatic symptoms. Severe symptoms, signs and life events were selected for analysing their relation to depression with somatic symptoms. Results: The adolescents with depressive disorders experienced considerably more somatic symptoms than their healthy controls. The duration and depth of the depression correlated with the number of somatic symptoms. There was a strong correlation between depression with many somatic symptoms and suicidal plans/thoughts, suicidal attempts, disruptive behaviour, as well as multiple stressful relationships. Conclusion: This study demonstrates that somatic symptoms are common in adolescent depression. Multiple somatic symptoms within depression imply a higher severity in terms of duration, depth and psychiatric comorbidity. The strong correlation with suicidal plans, suicidal attempts and disruptive behaviour is concerning.

Place, publisher, year, edition, pages
2010. Vol. 99, no 11, 1724-1730 p.
Keyword [en]
Adolescent depression, Somatic symptoms, Severity of depression
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-134185DOI: 10.1111/j.1651-2227.2010.01906.xISI: 000282641600024OAI: oai:DiVA.org:uu-134185DiVA: diva2:371622
Available from: 2010-11-22 Created: 2010-11-22 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Adolescents with Depression Followed up: Prognostic Significance of Somatic Symptoms and Their Need of In-Patient Care
Open this publication in new window or tab >>Adolescents with Depression Followed up: Prognostic Significance of Somatic Symptoms and Their Need of In-Patient Care
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A dualist approach that distinguishes between mind and body is still the norm in Western medicine. Although we now know that physical and mental health are related in adults, little is known about if, or with what mechanisms, mental illnesses or depression early in life, will affect future physical and psychological health. In-between mental and somatic disorders there are somatic symptoms without medical explanation. These are symptoms that cause much suffering and impairment which are costly for society. Still little is known what they are, how they should be treated and what consequences they have for adolescents when they grow up. This study aims to investigate the long-term relationship between mental and somatic disease and the outcome of adolescents with functional somatic symptoms.

The thesis is based on a 15-year follow-up study of a population-based investigation of adolescent depression. In 1991–1993 first year students in upper secondary school (age 16–17) in Uppsala, Sweden, were screened for depression (n=2300). Adolescents with positive screening and selected peers with negative screening (n=631) were assessed regarding mental health and somatic symptoms. At around age 31, the participants were followed-up in personal interviews (n=369) and national registers (n=609). Outcomes regarding mental DSM-IV diagnosis, in-patient ICD-10 disease diagnosis from the patient register, and blood vessel wall thickness were assessed.

The most important finding is the unexpected poor short and long-term outcome in adolescents with somatic symptoms. The result proves the need for better treatment. The strong prediction of functional somatic symptoms for mental disorder, independent of adolescent depression, suggests that somatic symptoms and depression symptoms are different expressions of a common disorder. Female adolescents with depression need more psychiatric and somatic in-patient care but the males do not. Instead, they have considerably more in-patient stays due to alcohol and drug abuse. The males might be taken care of outside the health care system and seem to need special attention. In women with adolescent and recurrent adult depression there is an association with premature aging of the carotid wall. These women are at risk of developing early cardio-vascular disease and need early interventions.

 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 40 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 809
National Category
Psychiatry
Research subject
Child and Youth Psychiatry
Identifiers
urn:nbn:se:uu:diva-180328 (URN)978-91-554-8461-3 (ISBN)
Public defence
2012-10-20, Universitetshuset, Sal IX, S:t Olofsgatan, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-09-28 Created: 2012-09-03 Last updated: 2013-01-23Bibliographically approved

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