title: Factors associated with internalizing or somatic symptoms in a cross-sectional study of school children in grades 1-10.
abstract: BACKGROUND
  School related factors that may contribute to children's subjective health have not been extensively studied. We assessed whether factors assumed to promote health and factors assumed to have adverse effects were associated with self-reported internalizing or somatic symptoms.
  
  
  METHODS
  In a cross-sectional study, 230 boys and 189 girls in grades 1-10 from five schools responded to the same set of questions. Proportional odds logistic regression was used to assess associations of school related factors with the prevalence of sadness, anxiety, stomach ache, and headache.
  
  
  RESULTS
  In multivariable analyses, perceived loneliness showed strong and positive associations with sadness (odds ratio, 1.94, 95% CI 1.42 to 2.64), anxiety (odds ratio, 1.78, 95% CI 1.31 to 2.42), and headache (odds ratio, 1.47, 95% CI 1.10 to 1.96), with consistently stronger associations for girls than boys. Among assumed health promoting factors, receiving necessary help from teachers was associated with lower prevalence of stomach ache in girls (odds ratio, 0.51, 95% CI 0.30 to 0.87).
  
  
  CONCLUSIONS
  These findings suggest that perceived loneliness may be strongly related to both internalizing and somatic symptoms among school children, and for girls, the associations of loneliness appear to be particularly strong.
authors.affiliation: Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. audhild.lohre@ntnu.no.
authors.forename: Audhild
authors.initials: A
authors.lastname: Løhre
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Vatten