Somatic and Posttraumatic Stress Symptoms in Children and Adolescents in France, 2024, Fernandez et al

Key Points

Question Are somatic symptoms associated with traumatic experiences in children and adolescents?

Findings In this cross-sectional study of 363 youths aged 7 to 17 years, those with a history of trauma exhibited significantly more frequent and intense somatic symptoms, including migraines, heart rate acceleration, nausea, fatigue, and sleep disorders.

Meaning These results suggest that collaboration between pediatricians and mental health professionals is essential for early identification and comprehensive care for children and adolescents with trauma-related somatic symptoms.

Abstract

Importance Somatic symptoms are a major concern among the pediatric population because of frequency and burden. The association between adverse childhood experiences and somatic symptoms in adults is well established but less is known concerning somatic symptoms in young people.

Objective To explore the frequency and intensity of somatic symptoms in children and adolescents exposed to traumatic events.

Design, Setting, and Participants This cross-sectional study was conducted from January 1 to December 31, 2021, at the Nice Pediatric Psychotrauma Referral Center in Nice, France. Participants included pediatric outpatients, aged 7 to 17 years, who were referred to the center. Statistical analysis was performed in January 2022.

Exposure All participants experienced at least 1 traumatic event during life.

Main Outcome and Measure Somatic and posttraumatic stress symptoms were assessed using the Patient Health Questionnaire-13 (PHQ–13) and Child PTSD Checklist (CPC). Posttraumatic stress disorder (PTSD) and non-PTSD groups were defined based on CPC symptoms severity score. In the hypothesized association between somatic symptoms and posttraumatic stress symptoms (PTSS), PTSD and non-PTSD groups were compared, correlations between PTSS and severity of CPC were analyzed, and a regression model was performed.

Results There were 363 participants included (mean [SD] age, 13.58 [0.25] years; 174 [47.9%] female, 189 [52.1%] male). Compared with the non-PTSD group, the PTSD group presented with a higher mean (SD) number of somatic symptoms (7.0 [2.5] vs 4.0 [2.5] symptoms; t360 = 11.7; P < .001), and higher mean (SD) intensity (10.4 [4.6] vs 4.8 [3.7] points; t360 = 12.6; P < .001). Most of the explored somatic symptoms positively correlated with the intensity of PTSS and their functional alterations (eg, PTSS intensity correlated with stomach pain symptoms [r = .30; P < .001]; and with headaches symptoms [r = .44; P < .001]). In the regression model, the combination of migraines, palpitation, nausea, tiredness, and sleep disorders explained 6.5% of the variance in the PTSD group. (F1,341 = 22.651; P < .001).

Conclusions and Relevance In this cross-sectional study, somatic symptoms were positively correlated with PTSS both in frequency and intensity among youths. These results suggest that the systematic screening for somatic symptoms in youths with traumatic exposure should be a routine evaluation procedure.

Open access, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817811