Egger H L, Costello E J, Erkanli A, Angold A
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
J Am Acad Child Adolesc Psychiatry. 1999 Jul;38(7):852-60. doi: 10.1097/00004583-199907000-00015.
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.
Data from 4 annual waves of interviews with 9- to 16-year-olds from the Great Smoky Mountains Study were analyzed.
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.
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.
在一个以人群为基础的儿童和青少年样本中，研究躯体主诉与《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）定义的抑郁症、焦虑症、品行障碍、对立违抗性障碍和注意力缺陷多动障碍之间的关联。
对来自大烟山研究的9至16岁儿童进行的4次年度访谈数据进行分析。
总体而言，躯体主诉在女孩中与情绪障碍密切相关，在男孩中与破坏性行为障碍密切相关。对女孩来说，胃痛和头痛共同出现以及单独的肌肉骨骼疼痛与焦虑症有关。对男孩来说，胃痛与对立违抗性障碍和注意力缺陷多动障碍有关。肌肉骨骼疼痛在女孩和男孩中均与抑郁症有关。
躯体主诉与精神病理学之间存在性别、疾病和主诉特异性的关联。男孩和女孩在这些关联背后的心理生物学过程似乎存在差异。临床建议包括，对于持续主诉头痛胃痛或肌肉骨骼疼痛的儿童和青少年，筛查其精神疾病，同时要意识到性别可能会影响与躯体主诉相关的精神病理学类型。
