Interdisciplinary Center for Psychiatric Epidemiology, CC 72, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, Netherlands.
Pediatrics. 2011 Sep;128(3):553-9. doi: 10.1542/peds.2010-2364. Epub 2011 Aug 1.
Functional somatic symptoms, symptoms for which no organic pathologic basis can be found, are more prevalent in girls than in boys, and this difference tends to increase during adolescence. This might be explained, at least in part, by pubertal development. We hypothesized that pubertal maturation predicts the development of most functional somatic symptoms and that this especially is true for girls.
We used 2 longitudinal population-based studies to examine our hypotheses: the Longitudinal Study of Pain in Adolescents in Seattle (n = 1996 [49.7% girls]) and the Dutch Tracking Adolescents' Individual Lives Survey (n = 2230 [51.0% girls]). Two assessment waves of each study were used. American adolescents were younger than Dutch adolescents at the first (11.6 vs 13.6) and second (14.5 vs 16.2) assessment waves, but they were in about the same pubertal development stage. Functional somatic symptoms were measured by pain questions, the Symptom Checklist-90, and the Youth Self-report. The Pubertal Development Scale was used to assess pubertal development on a continuous scale in both cohorts.
Ordinal logistic regression analyses revealed that American and Dutch adolescents at a later pubertal status at baseline were more likely (odds ratios ranged from 1.24 to 1.61) to report back pain, overtiredness, and dizziness but not stomach pain and headache 2 to 3 years later. Although these relationships were not equally strong for boys and girls, no significant gender differences were found.
Pubertal status predicted the frequency of some, but not all, functional somatic symptoms at follow-up.
功能性躯体症状是指无法找到器质性病理基础的症状，这类症状在女孩中比男孩更为常见，且这种差异在青春期期间有增大趋势。这种现象至少部分可以用青春期发育来解释。我们假设青春期成熟度可以预测大多数功能性躯体症状的发展，且这种预测在女孩中更为明显。
我们使用了两项基于人群的纵向研究来检验我们的假设：西雅图青少年疼痛纵向研究（n=1996 [49.7%为女性]）和荷兰青少年个体生活追踪调查（n=2230 [51.0%为女性]）。这两项研究都使用了两次评估。美国青少年在第一次（11.6 岁对 13.6 岁）和第二次（14.5 岁对 16.2 岁）评估时比荷兰青少年年龄小，但他们处于相似的青春期发育阶段。功能性躯体症状通过疼痛问卷、症状检查表-90 和青少年自我报告来衡量。青春期发育量表用于在两个队列中连续评估青春期发育情况。
有序逻辑回归分析显示，基线时青春期发育程度较高的美国和荷兰青少年在 2 到 3 年后更有可能报告背痛、过度疲劳和头晕（比值比范围为 1.24 至 1.61），但不太可能报告胃痛和头痛。尽管这些关系在男孩和女孩之间并不完全相同，但未发现显著的性别差异。
青春期成熟度可以预测随访时某些但不是所有功能性躯体症状的发生频率。
