Impact of functional somatic symptoms on 5–7-year-olds' healthcare use and costs

Græsholt-Knudsen, Troels; Skovgaard, Anne Mette; Jensen, Jens Søndergaard; Rask, Charlotte Ulrikka

doi:10.1136/archdischild-2016-311808

Cited by 16 publications

(11 citation statements)

References 38 publications

(53 reference statements)

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“…To our knowledge, only one previous study has investigated the association between non-specific health complaints and future health care use. This study found higher healthcare use in Danish children with functional somatic symptoms at the age of 5-7 years 29 . Functional somatic symptoms are comparable to non-specific health complaint, except that the former primarily refers to medically unexplained somatic complaints.…”

Section: Discussionmentioning

confidence: 49%

“…Given that health behavior is established in childhood and adolescence, it seems relevant to investigate how self-rated health and the experience of frequent non-specific health complaints in youth affect the contact pattern to primary health care over time [21][22][23][24] . The few existing studies in this area have mainly been cross-sectional 7,[25][26][27][28][29] .…”

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confidence: 99%

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Non-specific Health complaints and self-rated health in pre-adolescents; impact on primary health care use

Rytter

Rask

Vestergaard

et al. 2020

Sci Rep

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The objective of the present study was to explore past and future primary health care use in preadolescents reporting frequent non-specific health complaints or a low self-rated health compared to that of preadolescents with no frequent health complaints or with good self-rated health. The study was conducted as a cohort study based within the Danish National Birth Cohort (1996-2002). Information on non-specific health complaints and self-rated health was obtained by an 11-year follow-up questionnaire. Information about number of general practitioner (GP) contacts was obtained from the Health Insurance Service Register. A total of 44,877 pre-adolescents gave complete exposure information. Pre-adolescents who reported frequent non-specific health complaints had a higher use of GP compared to pre-adolescents without complaints across the five years following the index date (somatic complaints: IRR = (1.46 [1.38; 1.55], mental complaints: IRR = 1.16 [1.12; 1.19], both complaints: IRR = 1.58 [1.47; 1.69]). The same pattern was found for the association between low self-rated health and number of GP contacts (IRR = 1.41 (1.36; 1.46)). Non-specific health complaints and a poor self-rated health in pre-adolescents was associated with a higher past and future use of GP, indicating a need for development of early interventions with help for symptom management.

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Section: Discussionmentioning

confidence: 49%

mentioning

confidence: 99%

Non-specific Health complaints and self-rated health in pre-adolescents; impact on primary health care use

Rytter

Rask

Vestergaard

et al. 2020

Sci Rep

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“…FSS in children and adolescents are associated with increased societal costs including extensive health care visits [98,99], school absence and parental absence from work [100]. Considering the suggested clinically relevant improvements in self-reported physical health and the high treatment satisfaction rated by the adolescents and parents and as observed in a good adherence rate, AHEAD may have the potential to improve quality of life and reduce illness-related impairment.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: a pilot study

et al. 2020

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Background Recurrent and impairing functional somatic syndromes (FSS) are common in adolescents. Despite a high need for care, empirically supported treatments are lacking for youth. The aim of this uncontrolled pilot study was to assess feasibility and treatment potential of a new intervention with group-based Acceptance and Commitment Therapy (ACT) in a generic treatment approach for adolescents with multiple FSS. Methods Twenty-one patients received ‘ACT for Health in Adolescents’ (AHEAD) (30 h), specifically developed for adolescents (aged 15–19 years) with moderate to severe FSS. Close relatives attended an information meeting to facilitate support of the patients throughout treatment. Treatment satisfaction was evaluated by means of self-report and relatives’ impressions. Self-reported physical health at 3 months follow-up (FU) after end of treatment was the primary outcome whereas secondary outcomes included symptom burden, limitation due to symptoms, illness worry, emotional distress and physical and emotional symptoms. Treatment targets were assessed by measures on illness behaviour, illness perception and psychological inflexibility. Results Nineteen patients (90.5%) completed the treatment with a high overall attendance rate of 93%. All would recommend the treatment to a friend with similar problems. Close relatives rated it valuable to participate in an information meeting. Patients’ physical health improved significantly from assessment to FU with a clinically relevant mean change of 8.9 points (95% CI [5.4; 12.4]; SRM 0.91 [0.26;1.57]). Improvement was also seen on all secondary outcome measures, from assessment to FU. Maladaptive illness behaviours and perceptions as well as psychological inflexibility showed a significant decline from assessment to FU. Conclusion AHEAD was feasible and potentially efficacious and warrants testing in a larger clinical trial. Trial registration Clinical Trials gov NCT04464447, registration date July 9th, 2020. Retrospectively registered.

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“…The experience of somatic symptoms, such as gastrointestinal pain, headache, back pain and tiredness, is common in the general population [ 1 , 2 ]. Somatic symptoms are expensive in terms of direct costs for health care but also in a wider societal perspective due to decreased productivity [ 3 , 4 ]. Research over the two past decades has documented that somatic symptoms are also common in community-based samples of children and adolescents, particularly among girls [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Somatic symptoms in adolescence as a predictor of severe mental illness in adulthood: a long-term community-based follow-up study

Bohman

Låftman

Cleland

et al. 2018

Child Adolesc Psychiatry Ment Health

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BackgroundSomatic symptoms are common and costly for society and correlate with suffering and low functioning. Nevertheless, little is known about the long-term implications of somatic symptoms. The objective of this study was to assess if somatic symptoms in adolescents with depression and in their matched controls predict severe mental illness in adulthood by investigating the use of hospital-based care consequent to different mental disorders.MethodsThe entire school population of 16–17-year-olds in the city of Uppsala, Sweden, was screened for depression in 1991–1993 (n = 2300). Adolescents with positive screenings (n = 307) and matched non-depressed controls (n = 302) participated in a semi-structured diagnostic interview for mental disorders. In addition, 21 different self-rated somatic symptoms were assessed. The adolescents with depression and the matched non-depressed controls were engaged in follow-up through the National Patient Register 17–19 years after the baseline study (n = 375). The outcome measures covered hospital-based mental health care for different mental disorders according to ICD-10 criteria between the participants’ ages of 18 and 35 years.ResultsSomatic symptoms were associated with an increased risk of later hospital-based mental health care in general in a dose–response relationship when adjusting for sex, adolescent depression, and adolescent anxiety (1 symptom: OR = 1.63, CI 0.55–4.85; 2–4 symptoms: OR = 2.77, 95% CI 1.04–7.39; ≥ 5 symptoms: OR = 5.75, 95% CI 1.98–16.72). With regards to specific diagnoses, somatic symptoms predicted hospital-based care for mood disorders when adjusting for sex, adolescent depression, and adolescent anxiety (p < 0.05). In adolescents with depression, somatic symptoms predicted later hospital-based mental health care in a dose–response relationship (p < 0.01). In adolescents without depression, reporting at least one somatic symptom predicted later hospital-based mental health care (p < 0.05).ConclusionsSomatic symptoms in adolescence predicted severe adult mental illness as measured by hospital-based care also when controlled for important confounders. The results suggest that adolescents with somatic symptoms need early treatment and extended follow-up to treat these specific symptoms, regardless of co-occurring depression and anxiety.Electronic supplementary materialThe online version of this article (10.1186/s13034-018-0245-0) contains supplementary material, which is available to authorized users.

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Impact of functional somatic symptoms on 5–7-year-olds' healthcare use and costs

Cited by 16 publications

References 38 publications

Non-specific Health complaints and self-rated health in pre-adolescents; impact on primary health care use

Non-specific Health complaints and self-rated health in pre-adolescents; impact on primary health care use

Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: a pilot study

Somatic symptoms in adolescence as a predictor of severe mental illness in adulthood: a long-term community-based follow-up study

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