Epidemiology of Somatoform Symptoms and Disorders in Childhood and Adolescence: A Systematic Review and Meta-Analysis

Abstract

The aim of the current systematic review and meta-analysis was to examine the prevalence and incidence of somatoform symptoms and disorders (also referred to as medically unexplained symptoms, psychosomatic symptoms, functional syndromes, somatization disorder, or somatic symptom disorder) in childhood and adolescence. The PRISMA guidelines were followed, and the review was registered prior to initiation (PROSPERO CRD42022339735). Fitting search terms were entered in Web of Science, Scopus, and PubMed in June, 2022. Included were articles, reports, book chapters, and conference papers that reported on the prevalence or incidence rates of somatoform symptoms and disorder in under-18-year-olds with empirical primary data; these needed to be published in English or German. Publications were excluded if they focused on abuse, trauma, serious illness, or hypochondria, as well as if they had a qualitative or experimental (intervention) study design. To be included in the meta-analysis, studies needed to report values suitable to calculate a pooled prevalence or incidence rate. After the full-text screening, 33 articles remained, of which 29 were used for the meta-analysis. The quality evaluation criteria proposed by Loney and colleagues (1998) were utilized for quality assessment. The pooled global prevalence rate was 31.0% for somatoform symptoms and 3.3% for somatoform disorders, yet heterogeneity remained high. The noteworthy prevalence rates have important implications for healthcare professionals, as well as school nurses and counselors.

Prevalence of Somatic Symptoms and Somatoform Disorders among a German Adolescent Psychiatric Inpatient Sample

“…In a prospective longitudinal study among 3021 adolescents in a community cohort, subthreshold somatoform disorders occurred in 2.7% of the sample [4]. A comparable rate of 3.3% has lately been confirmed in a meta-analysis covering research over the past two decades [5]. Retrospective studies among adults point to the onset of somatoform disorders during adolescence.…”

“…In summary, somatic symptoms are relevant and impairing with respect to everyday functioning [ 22 ]. They present quite frequently in general child and adolescent populations [ 4 , 5 ], and are closely intertwined with symptoms of depression [ 30 ] and anxiety [ 32 ]. Therefore, especially among children and adolescents in mental health care settings, the early identification of somatic symptoms bears the potential to effectively treat and prevent chronic somatoform disorders.…”

Inflammatory Markers in Children and Adolescents with Functional Somatic Disorders: A Systematic Review

“…Studies were considered eligible for data extraction if they met the following inclusion criteria: (1) children or adolescents (aged 0-17 years, both included), (2) patients diagnosed with an FSD, (3) measurement of systemic inflammatory markers, (4) studies including a control group without an FSD, and (5) studies written in English. The exclusion criteria were (1) animal experiments, (2) in vitro experiments, (3) case studies, (4) studies measuring inflammatory response exclusively in feces, biopsies, and urine (i.e., not systemic markers).…”

“…Mild transient physical symptoms are common among children and adolescents; still, the exact number suffering from FSDs remains unknown. A recent meta-analysis found a prevalence rate of 3.3% for FSDs in children and adolescents, and the prevalence is possibly increasing [2,3]. At this severe end of the spectrum, the symptoms typically result in significant disruption of the daily life of the child or adolescent with school absenteeism and social withdrawal and moreover often lead to high levels of health service use [4,5].…”

Clinical Impact of Systematic Assessment and Psychoeducation in Specialized Treatment of Adolescents with Severe Functional Somatic Disorders: Results from the AHEAD Study

“…Functional somatic disorders (FSD), defined as disorders with distinct patterns of impairing physical symptoms with no clear medical explanation [1], are increasingly common in adolescents with current prevalence estimates of 3-10% [2][3][4][5]. The etiology of FSD is best understood within the bio-psycho-social model with often complex interacting biological and psychosocial factors for symptom development and maintenance [6].…”