title: Somatic symptoms and psychological concerns in a general adolescent population: Exploring the relevance of DSM-5 somatic symptom disorder.
abstract: OBJECTIVE
  DSM-5 somatic symptom disorder (SSD) constitutes a major change for psychosomatic medicine and psychiatry, as well as for epidemiological research in these fields. This study investigates somatic symptoms and psychological concerns among adolescents in order to systematically explore the relevance of SSD for general adolescent populations.
  
  
  METHODS
  A cross-sectional population-based design, with a symptoms-based strategy and a symptom-and-psychological-concern-based strategy, was used to estimate the prevalence of somatic symptoms and psychological concerns in a general adolescent population (n=2476, mean age=16years, 49% boys, 51% girls). Somatic symptoms and psychological concerns in relation to gender, and self-reported medical and psychiatric conditions were investigated. The association between somatic symptoms, psychological concerns, and functional impairment in school-, family-, peer- and physical activities was studied.
  
  
  RESULTS
  Reporting 3+ persistent distressing somatic symptoms was significantly more common than reporting one or more persistent distressing somatic symptom(s) combined with serious psychological concern. The prevalence of such complaints was significantly higher in girls. The proportion of medical and psychiatric conditions was highest in the group reporting 3+ persistent distressing somatic symptoms combined with serious psychological concern. Belonging to this group most significantly increased odds ratios for functional impairment.
  
  
  CONCLUSIONS
  For large-scale studies on SSD, results suggest the use of measures based on multiple somatic items in combination with psychological concerns, and a methodologically sound standardized measure of functional impairment. To further enhance clinical decision-making, the relation of symptoms to functional impairment, and the substantial overlap of SSD with medical and psychiatric conditions during adolescence should be addressed.
authors: Centre for Research on Child and Adolescent Mental Health, Karlstad University, 65188 Karlstad, Sweden. Electronic address: stefan.vangeelen@kau.se.
authors: Stefan M
authors: SM
authors: van Geelen
authors: Centre for Research on Child and Adolescent Mental Health, Karlstad University, 65188 Karlstad, Sweden.
authors: Per-Anders
authors: PA
authors: Rydelius
authors: Centre for Research on Child and Adolescent Mental Health, Karlstad University, 65188 Karlstad, Sweden.
authors: Curt
authors: C
authors: Hagquist
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D011611:Psychosomatic Medicine / Q000379:methods*; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Adolescent mental health; DSM-5; Functional impairment; Medical and psychiatric conditions; Medically unexplained symptoms; Somatic symptom disorder