Frequency and number of somatic symptoms in association with depressive symptoms in Japanese children aged 10-15: a population-based study

Eur J Pediatr. 2025 Aug 20;184(9):564. doi: 10.1007/s00431-025-06399-9.

ABSTRACT

This study investigated the association between the frequency and number of major somatic symptoms (headache, stomachache, back pain, dizziness) and depressive symptoms among adolescents. We conducted a nationwide, population-based self-reported questionnaire survey of adolescents aged 10-15. We defined depressive symptoms as scoring 10 or higher on the Patient Health Questionnaire for Adolescents. We calculated adjusted risk ratios using modified Poisson regression and examined diagnostic accuracy with univariate and multivariate receiver operating characteristic analysis. Among 2268 adolescents, 254 (11.2%) had depressive symptoms; 218 (85.8%) experienced at least one somatic symptom once a month or more. The risk of depressive symptoms increased with the number of somatic symptoms reported more than once a month, from a risk ratio of 2.7 (95% confidence interval [95%CI], 1.7-4.1) for one symptom to 16.4 (95%CI, 11.2-24.2) for four, compared to no symptoms. Any somatic symptoms once a month were associated with depressive symptoms with 85.8% sensitivity, while three or more somatic symptoms had 92.8% specificity. Models classifying depressive symptoms by the number of somatic symptoms performed moderately well (area under the curve, 0.80 [95%CI, 0.76-0.82]) and outperformed models based on the frequency of any single somatic symptom.

CONCLUSION: This population-based study found that the risk of depressive symptoms increases with both the number of symptoms observed at least once a month and the frequency of somatic symptoms. Monitoring the frequency and number of somatic symptoms may offer an efficient, low-threshold screening method for depressive symptoms in adolescents.

WHAT IS KNOWN: • Depressive symptoms are common in adolescents and impose heavy health, social, and economic burdens. • Somatic symptoms frequently co-occur with depressive symptoms, complicating early detection and intervention.

WHAT IS NEW: • This population-based study highlights that both the frequency and number of somatic symptoms are associated with depressive symptoms. • Monitoring multiple and frequent somatic symptoms may offer a practical, low-threshold approach to identifying adolescents at risk of depressive symptoms.

PMID:40830679 | DOI:10.1007/s00431-025-06399-9