Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches.
OBJECTIVE
To examine the associations of somatic complaints with DSM-III-R-defined depression, anxiety disorders, conduct disorder, oppositional defiant disorder, and attention-deficit hyperactivity disorder in a population-based sample of children and adolescents.


METHODS
Data from 4 annual waves of interviews with 9- to 16-year-olds from the Great Smoky Mountains Study were analyzed.


RESULTS
Overall, somatic complaints were strongly associated with emotional disorders in girls and with disruptive behavior disorders in boys. For girls, stomach aches and headaches together and musculoskeletal pains alone were associated with anxiety disorders. For boys, stomach aches were associated with oppositional defiant disorder and attention-deficit hyperactivity disorder. Musculoskeletal pains were associated with depression in both girls and boys.


CONCLUSIONS
There were gender-, illness- and complaint-specific associations between somatic complaints and psychopathology. It appears likely that there are differences in the psychobiological processes underlying these associations in boys and girls. Clinical recommendations include screening children and adolescents with persistent complaints of headaches, stomach aches, or musculoskeletal pains for psychiatric disorders with an awareness that gender may affect the type of psychopathology associated with the somatic complaints.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. hegger@psych.mc.duke.edu
H L
HL
Egger
E J
EJ
Costello
A
A
Erkanli
A
A
Angold
D015746:Abdominal Pain / Q000453:epidemiology; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D017677:Age Distribution; D002648:Child; D002652:Child Behavior / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006261:Headache / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D017678:Sex Distribution; D013001:Somatoform Disorders / Q000453:epidemiology*