Dataset Information

Exploring the course of functional somatic symptoms (FSS) from pre- to late adolescence and associated internalizing psychopathology - an observational cohort-study.

ABSTRACT:

Background

Functional somatic symptoms (FSS), which commonly cannot be attributed to well-defined organic pathology, often co-occur with internalizing psychopathology and fluctuate throughout different life stages. We examined FSS courses throughout adolescence, and the association between preadolescent FSS, FSS severity and internalizing psychopathology at late adolescence.

Methods

Data from the Copenhagen Child Cohort (CCC2000) were utilized from assessments at ages 11-12 years (preadolescence; T0) and 16-17 years (late adolescence; T1). Self-report questionnaire and interview data on FSS, internalizing psychopathology, chronic medical conditions, and sociodemographic data from Danish national registers were available for 1285 youths. FSS courses were categorized into persistent (high FSS at T0 & T1), remission (high FSS only at T0), incident (high FSS only at T1) or no FSS (no FSS at T0 & T1). Multiple linear and multinomial logistic regressions were conducted to investigate the FSS/psychopathology association.

Results

1.8% of adolescents fell into the persistent FSS course group throughout adolescence. Higher preadolescent FSS predicted FSS (b = 0.07, p < .001), anxiety (b = 0.05, p < .001) and depression (b = 0.06, p < .001) at age 16/17, even after controlling for sex, parental education, a chronic medical condition and internalizing psychopathology in preadolescence. Persistent, incident, and remittent FSS courses were associated with significantly higher mean levels of anxiety and depression compared to the reference group (no FSS).

Conclusions

FSS during pre- and late adolescence might increase and co-occur with anxiety and depression throughout adolescence, potentially due to shared underlying risk factors and processes.

SUBMITTER: Munker L

PROVIDER: S-EPMC11232134 | biostudies-literature | 2024 Jul

REPOSITORIES: biostudies-literature

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Publications

Exploring the course of functional somatic symptoms (FSS) from pre- to late adolescence and associated internalizing psychopathology - an observational cohort-study.

Münker Lina L Rimvall Martin Køster MK Frostholm Lisbeth L Ørnbøl Eva E Wellnitz Kaare Bro KB Jeppesen Pia P Maria Rosmalen Judith Gerarda JG Rask Charlotte Ulrikka CU

BMC psychiatry 20240708 1

<h4>Background</h4>Functional somatic symptoms (FSS), which commonly cannot be attributed to well-defined organic pathology, often co-occur with internalizing psychopathology and fluctuate throughout different life stages. We examined FSS courses throughout adolescence, and the association between preadolescent FSS, FSS severity and internalizing psychopathology at late adolescence.<h4>Methods</h4>Data from the Copenhagen Child Cohort (CCC2000) were utilized from assessments at ages 11-12 years ...[more]

PMID: 38977964

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Project description:Physiological regulatory problems in infancy (i.e., problems with sleeping, feeding, and tactile reactivity) have been associated with impairing functional somatic symptoms (FSS) at ages 5-7. We aimed to extend this finding by examining not only the association of physiological regulatory problems but also other infancy factors (i.e., emotion dysregulation and contact problems) with FSS in pre- and late adolescence. Standardized behavioral assessments and self-report questionnaire data from assessment waves at 0-1, 11-12, and 16-17 years of the population-based Copenhagen Child Cohort (CCC2000) were linked with Danish register data on maternal postpartum psychiatric illness and family adversity as covariates. Multiple linear regression analyses were performed to examine the association between infancy factors and FSS in pre- and late adolescence. Only infancy physiological regulatory problems significantly predicted preadolescent FSS (b = 0.38, 95% CI [0.14, 0.62]), also when accounting for maternal postpartum psychiatric illness and family adversity. The association was attenuated for late adolescent FSS.ConclusionInfancy physiological regulatory problems may represent early signs of a dysregulated stress system and were found to significantly predict FSS in pre- but not late adolescence. Implications for early FSS prevention could include testing interventions promoting infants' regulation of sleep, feeding, and tactile reactivity.What is known• Functional somatic symptoms (FSS) are common in adolescence. • Explanatory models of FSS emphasize a multifactorial etiology involving interactions between early child-related vulnerabilities and contextual factors. • Infancy physiological regulatory problems (i.e., problems in the area of sleeping, feeding, and tactile reactivity) might represent early signs of a dysregulated stress system, and have been shown to predict impairing FSS in preschool childhood.What is new• This study investigated the association between infancy factors, namely physiological regulatory problems with feeding, sleeping, and/or tactile reactivity, emotion dysregulation, and contact problems, and FSS in pre- and late adolescence. • Only a combination of infancy physiological regulatory problems significantly predicted preadolescent FSS, with the association attenuating for FSS in late adolescence. • Implications for early FSS prevention could include parent-mediated interventions aiming to promote infants' physiological regulatory skills.

Project description:ImportanceThe understanding of the development of psychopathology has been hampered by a reliance on cross-sectional data and symptom- or disorder-centered methods. Person-centered methods can accommodate both the problems of comorbidity and the movement between different psychopathological states at different phases of development.ObjectiveTo examine the profiles and map the trajectories of psychopathology from early childhood to late adolescence.Design, setting, and participantsThis cohort study used 2 longitudinal nationally representative community-based cohorts from the Growing Up in Ireland study covering developmental periods from early childhood to late adolescence. Data in this investigation came from children and their families who participated in all waves of cohorts recruited in 2008 (children ages 3, 5, and 9 years) and 1998 (adolescents ages 9, 13, and 17 or 18 years). Both samples were weighted to account for representation and attrition. Latent transition analyses were used to map the trajectories of psychopathology. Data were analyzed between October 2020 and September 2021.Main outcomes and measuresPsychopathology was measured using the Strengths and Difficulties Questionnaire at all ages in both samples.ResultsA total of 13 546 individuals were included in the analyses. In the child cohort, mean (SD) age was 3.0 [0.01] years; 3852 (51.3%) were male participants. In the adolescent cohort, mean age was 9.0 (0.1) years; 3082 (51.0%) were male participants. Four profiles were identified in both cohorts that could be broadly labeled as no psychopathology (incidence range, 60%-70%), high psychopathology (incidence range, 3%-5%), externalizing problems (incidence range, 15%-25%), and internalizing problems (incidence range, 7%-12%). Transition between the profiles was common in both cohorts, with 3649 of 7507 participants (48.6%) in the child cohort and 2661 of 6039 participants (44.1%) in the adolescent cohort moving into 1 of the 3 psychopathology profiles at some point in development. Transition to the high psychopathology profile was most often preceded by externalizing problems. Approximately 3% to 4% of the sample had persistent psychopathology (child cohort, 203 participants [2.7%]; adolescent cohort, 216 participants [3.6%]). All psychopathology profiles were more common in boys in early life but, by late adolescence, girls were more likely to have internalizing problems. In a cross-cohort comparison at age 9, there were differences in the sex distributions of the profiles between the samples.Conclusions and relevanceUsing person-centered methods, this study demonstrated that from early life young peoples' experience of psychopathology is dynamic-they can move between different mental health problems; for most children, these problems are transient, but a small proportion (fewer than 5%) have persistent difficulties. In the context of finite resources, optimizing care requires the early identification of those with persistent phenomena.

Project description:BackgroundInternalising and externalising problems commonly co-occur in childhood. Yet, few developmental models describing the structure of child psychopathology appropriately account for this comorbidity. We evaluate a model of childhood psychopathology that separates the unique and shared contribution of individual psychological symptoms into specific internalising, externalising and general psychopathology factors and assess how these general and specific factors predict long-term outcomes concerning criminal behaviour, academic achievement and affective symptoms in three independent cohorts.MethodsData were drawn from independent birth cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), N = 11,612; Generation R, N = 7,946; Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN), N = 408). Child psychopathology was assessed between 4 and 8 years using a range of diagnostic and questionnaire-based measures, and multiple informants. First, structural equation models were used to assess the fit of hypothesised models of shared and unique components of psychopathology in all cohorts. Once the model was chosen, linear/logistic regressions were used to investigate whether these factors were associated with important outcomes such as criminal behaviour, academic achievement and well-being from late adolescence/early adulthood.ResultsThe model that included specific factors for internalising/externalising and a general psychopathology factor capturing variance shared between symptoms regardless of their classification fits well for all of the cohorts. As hypothesised, general psychopathology factor scores were predictive of all outcomes of later functioning, while specific internalising factor scores predicted later internalising outcomes. Specific externalising factor scores, capturing variance not shared by any other psychological symptoms, were not predictive of later outcomes.ConclusionsEarly symptoms of psychopathology carry information that is syndrome-specific as well as indicative of general vulnerability and the informant reporting on the child. The 'general psychopathology factor' might be more relevant for long-term outcomes than specific symptoms. These findings emphasise the importance of considering the co-occurrence of common internalising and externalising problems in childhood when considering long-term impact.

Dataset Information

Exploring the course of functional somatic symptoms (FSS) from pre- to late adolescence and associated internalizing psychopathology - an observational cohort-study.

Background

Methods

Results

Conclusions

Publications

Exploring the course of functional somatic symptoms (FSS) from pre- to late adolescence and associated internalizing psychopathology - an observational cohort-study.

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