A Systematic Review of Somatic Symptoms in Children With a Chronically Ill Family Member

Abstract

Objective Somatization and functional somatic symptoms reflect conditions in which physical symptoms are not sufficiently explained by medical conditions. Literature suggests that these somatic symptoms may be related to illness exposure in the family. Children with a parent or sibling with a chronic illness may be particularly vulnerable to developing somatic symptoms. This study provides a systematic review of the literature on somatic symptoms in children with a chronically ill family member. Methods A systematic review (PROSPERO registry ID: CRD42018092344) was conducted using six databases (PubMed, EMBASE, PsychINFO, Scopus, CINAHL, and Cochrane) from articles published before April 5, 2018. All authors evaluated articles by title and abstract, and then by full-text review. Relevant data were extracted by the first author and reviewed by remaining authors. Results Twenty-seven unique studies met the criteria. Seventeen examined somatic symptoms in children with a chronically ill parent, and seven evaluated somatic symptoms in children with a chronically ill sibling. Three studies examined somatic symptoms in children with an unspecified ill relative. The strongest relationship between child somatization and familial illness was found with children with a chronically ill parent (13/17 studies). Evidence for somatic symptoms in children with an ill sibling was mixed (4/7 studies found a positive association). Conclusions The literature on somatic symptoms in children suggests that parental illness is related to increased somatic symptoms in children. Research examining the effects of having a sibling with an illness on somatic symptoms is mixed. Several areas of future research are outlined to further clarify the relationship between familial chronic illness and somatic symptoms.

A Model of the Effects of Parental Illness on Youth Adjustment and Family Functioning: The Moderating Effects of Psychological Flexibility on Youth Caregiving and Stress

“…Parental illness is associated with a significantly higher risk for youth mental and physical health problems, poorer health-related quality of life (HRQoL), and social, educational and employment difficulties that persist well into adulthood [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Moreover, having a parent with a chronic illness is related to a significantly higher risk for internalizing problems (e.g., depressive, anxiety, and somatic symptoms), externalizing problems (e.g., aggressive and delinquent behaviors), lower life satisfaction, and loneliness [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Compared to peers, the youth of chronically ill parents are also at higher risk of affective dysregulation, stress-related somatic disorders, and weakened immune responses [ 3 , 5 , 16 , 18 ].…”

“…Moreover, having a parent with a chronic illness is related to a significantly higher risk for internalizing problems (e.g., depressive, anxiety, and somatic symptoms), externalizing problems (e.g., aggressive and delinquent behaviors), lower life satisfaction, and loneliness [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Compared to peers, the youth of chronically ill parents are also at higher risk of affective dysregulation, stress-related somatic disorders, and weakened immune responses [ 3 , 5 , 16 , 18 ]. Parental illness is also related to poorer family functioning, which is associated with more family conflicts, less cohesion, and reduced communication which, in turn, are associated with poorer youth adjustment [ 3 , 5 , 7 , 19 , 20 ].…”

Parental Response to Only Children: Breaking the Stereotypes

“…They found children whose parents had a diagnosis of IBS had significantly higher healthcare utilization rates, not just for gastrointestinal symptoms but also for a wide range of somatic symptoms, as compared to a control group of children whose parents were not diagnosed with IBS. It is perhaps not surprising, then, that a recent systematic review of 27 studies of children with a chronically ill parent concluded that parental illness is related to increased somatic symptoms in children [ 26 ]. The relationship between increased somatic symptoms in children with chronically ill siblings was mixed, further highlighting the concept of intergenerational transmission [ 26 ].…”

“…It is perhaps not surprising, then, that a recent systematic review of 27 studies of children with a chronically ill parent concluded that parental illness is related to increased somatic symptoms in children [ 26 ]. The relationship between increased somatic symptoms in children with chronically ill siblings was mixed, further highlighting the concept of intergenerational transmission [ 26 ].…”

Why Do Some Adolescents Manage Despite Parental Illness? Identifying Promotive Factors

“…An estimated 10% of children have a parent with a chronic medical condition [1], and up to one in five experience parental mental illness [2]. Existing evidence has found that parental illness is associated with somatic symptoms [3] and internalizing problems, such as depressive and anxiety symptoms [1,4,5]. Studies have also shown that some adolescents experience benefit finding in relation to being a caregiver to an ill parent [6,7] and children with ill parents may experience increased maturity, strengthened family relations, and appreciation [8,9].…”