Predictors for Persistence of Functional Somatic Symptoms in Adolescents

Janssens, Karin A.M.; Klis, Sandor; Kingma, Eva M.; Oldehinkel, Albertine J.; Rosmalen, Judith

doi:10.1016/j.jpeds.2013.12.003

Cited by 47 publications

(52 citation statements)

References 28 publications

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“…While females with CSI scores less than 13 had PCSS scores within the normal range at 4 weeks, and those with CSI scores 13 and above had persistent concussion symptoms at both 2 and 4 weeks. In a population cohort of non-concussed individuals, Janssens et al reported that females were more likely than males to report persistent functional somatic symptoms with the Youth Self-Report and Child Behavior Checklist 27 That observation is consistent with our findings in a selected cohort of females with concussion. Our study links somatization as a possible explanation for the higher concussion symptom scores and longer recovery times reported for females in the literature.…”

Section: Discussionsupporting

confidence: 92%

History of Somatization Is Associated with Prolonged Recovery from Concussion

Root

Zuckerbraun

Wang

et al. 2016

The Journal of Pediatrics

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Objective To determine the association between a history of somatization and prolonged concussion symptoms, including sex differences in recovery. Study design A prospective cohort study of 10–18 year olds with an acute concussion was conducted from July 2014 to April 2015 at a tertiary care pediatric emergency department. 120 subjects completed the validated Children’s Somatization Inventory (CSI) for pre-injury somatization assessment and Post-Concussion Symptoms Score (PCSS) at diagnosis. PCSS was re-assessed by phone at 2- and 4-weeks. CSI was assessed in quartiles with a generalized estimating equation model to determine relationship of CSI to PCSS over time. Results The median age of our study participants was 13.8 years (interquartile range: 11.5, 15.8), 60% male, with analyses carried out separately for each sex. Our model showed a positive interaction between total CSI score, PCSS and time from concussion for females p < 0.01, and a statistical trend for males, p = 0.058. Females in the highest quartile of somatization had higher PCSS than the other three CSI quartiles at each time point (B −26.7 to −41.1, p-values < 0.015). Conclusions Patients with higher pre-injury somatization had higher concussion symptom scores over time. Females in the highest somatization quartile had prolonged concussion recovery with persistently high symptom scores at 4 weeks. Somatization may contribute to sex differences in recovery, and assessment at the time of concussion may help guide management and target therapy.

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Section: Discussionsupporting

confidence: 92%

History of Somatization Is Associated with Prolonged Recovery from Concussion

Root

Zuckerbraun

Wang

et al. 2016

The Journal of Pediatrics

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“…Janssens et al [3] studied the development of a score of seven FSS over a 7-years time span among Dutch teens aged from 11 to 16 years on average in the three waves of data collection. In their four-trajectory solution the group with low symptoms was the largest and the group with persistent FSS the smallest, similar to our findings.…”

Section: Discussionmentioning

confidence: 99%

“…There are only few studies that analyse FSS in longitudinal settings. Rousseau et al [14] and Janssens et al [3] have used latent growth mixture model [11] when investigating the trajectories of FSS and their association with background characteristics in adolescence. The trajectory analysis by Nagin [12] was used by Mulvaney et al [10] in the study of children suffering from abdominal pain.…”

Section: Introductionmentioning

confidence: 99%

Trajectories of a set of ten functional somatic symptoms from adolescence to middle age

et al. 2017

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Background: Functional somatic symptoms (FSS), or symptoms without a clear medical explanation are a considerable challenge for health care systems. There is no general consensus as to which symptoms should be regarded functional. Few longitudinal studies on the development of FSS exist and these have mainly been based on the assumption that the factorial structure of a FSS scores variable remains invariant over time. When the analysis covers longer periods of the life course, this may be challenged. The aim of our study was to investigate how ten functional somatic symptoms (FSS) evolve when individuals are ageing. Methods: The data of the Northern Swedish Cohort (n = 1001) from questionnaire surveys at ages 16, 18, 21, 30 and 42, were analysed. Participation rates remained very high over the five surveys. The list of symptoms included backache, breathlessness, dizziness, fatigue, headache or migraine, nausea, overstrain, palpitations, sleeplessness and stomach ache. We used multivariate trajectory analysis (TA) with logistic broken-stick regression models to describe sub-groups in the data. In multivariate TA the joint development of the set of item variables can be investigated. There is no need to construct a special FSS summary score variable. Results: Four well separated trajectories were identified. In two groups, healing symptoms (25.4% of the sample) and low symptom load (32.2% of the sample), the symptom level stayed relatively low in adulthood. In the third group of high symptom load (17.2%) the probability of having symptoms was high for all FSS variables. In the fourth group of increasing symptoms (25.3%) the level of symptoms was first intermediate, but increased markedly with age. Conclusions: Instead of a single FSS score we were able to assign each individual to one of four trajectories described jointly by 10 separate symptoms. The profile of development, but not the probability level, was rather similar over the symptoms within the trajectories, with few exceptions. The results provide better understanding of the longitudinal development of the symptoms from the adolescence to the middle age.

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“…Overall, persistent distressing somatic symptoms were significantly more common among girls than among boys (71.3% vs. 28.7%). Such an unequal gender-distribution in these specific types of problems during adolescence is universally recognized [1][2][3][4][5]21,30]. Indicates a significant difference in proportions (z-tests, p b .05) compared to a the No case group.…”

Section: Discussionmentioning

confidence: 99%