ABSTRACT
The aim of this study is at examining the prevalence and impact factors of adolescent somatization tendencies (ST) across three eastern Chinese provinces. A multicenter school-based cross-sectional study was conducted in these provinces from 2015 to 2016. The sample included 11,153 middle-school students aged 13-18 years, who were randomly selected using a multi-phase stratified cluster sampling technique. We also designed a multicenter school-based case-control study to evaluate the potential environmental impact of ST factors on this population. The overall positive rate of ST among the eastern Chinese adolescents was 12.1%. Somatic symptoms score (SSS) and positive ST rate were higher in females than males. Additionally, the SSS and positive ST rate for the 18-year-old group were significantly higher than in other age groups. In comparison to those in urban areas, adolescents in rural areas had significantly higher SSS and positive ST rate. Multiple conditional regression analyses revealed that family medical history, anxiety and depression scores; superstitious beliefs; left-behind adolescents; teacher-student support; family conflict; and family independence and achievement orientation were significantly linked to ST in adolescents. The models also indicated family medical history was the strongest impact factor to adolescent ST, even though ST were prevalent in the three studied eastern Chinese provinces. Gender, age, and dwelling differences were very significant in the SSS and positive ST rate in adolescents. This study concludes that adolescent ST are influenced by multiple environments.
O objetivo deste estudo é examinar a prevalência e fatores de impacto de tendências de somatização (TS) em adolescentes em três províncias do leste da China. Um estudo transversal multicêntrico baseado em escolas foi realizado nessas províncias de 2015 a 2016. A amostra incluiu 11.153 estudantes entre 13 e 18 anos que foram selecionados aleatoriamente usando uma técnica de amostragem estratificada por clusters multi-fase. Também elaboramos um estudo caso-controle multicêntrico baseado em escolas para avaliar o impacto ambiental potencial de fatores de TS nessa população. A taxa positiva geral de TS entre adolescentes do leste chinês foi de 12,1%. O escore de sintomas somáticos (SSS) e taxa positiva de TS foram mais altos entre mulheres do que homens. Adicionalmente, o SSS e taxa positiva de TS para o grupo de 18 anos foram significativamente mais altos do que em outros grupos etários. Em comparação com os habitantes de áreas urbanas, adolescentes de áreas rurais tiveram SSS e taxa positiva de ST significativamente mais altos. Análises de regressão múltipla condicional revelaram que o histórico de saúde da família; scores de ansiedade e depressão; crenças supersticiosas; adolescentes deixados para trás; apoio de professores a estudantes; conflito familiar; e independência familiar e orientação para sucesso estavam significativamente relacionadas a TS em adolescentes. O modelo também indicou que o histórico de saúde da família era o fator de impacto mais forte para TS em adolescentes, ainda que TS sejam prevalentes nas três províncias do leste da China estudadas. Gênero, idade e diferenças residenciais foram muito significativos para o SSS e taxa positiva de TS entre adolescentes. Este estudo conclui que TS entre adolescentes são influenciadas por múltiplos ambientes.
El objetivo de este estudio fue examinar la prevalencia y factores de impacto de las tendencias de somatización adolescentes (TS) en tres provincias orientales chinas. Se realizó un estudio trasversal multicéntrico, basado en escolares de estas provincias de 2015 a 2016. La muestra incluyó a 11.153 estudiantes de secundaria, con edades comprendidas entre los 13-18 años, que fueron seleccionados aleatoriamente, usando a técnicas de muestreo multifase estratificado por conglomerados. También se diseñó un estudio multicéntrico escolar de caso-control para evaluar el potencial impacto ambiental de factores TS en esta población. La tasa positiva general de TS entre adolescentes chinos orientales fue un 12,1%. El marcador de síntomas somáticos (SSS, por sus siglas en inglés) y tasa positiva de TS fueron más altos en mujeres que en hombres. Asimismo, las tasas SSS y TS positiva para el grupo de 18 años de edad fueron significativamente más altas que en otros grupos de edad. En comparación con quienes vivían en áreas urbanas, los adolescentes en áreas rurales contaban con tasas significativamente más altas de SSS y TS positivas. Los análisis de regresión múltiple condicional revelaron que el historial médico familiar, los marcadores de ansiedad y depresión; creencias supersticiosas; adolescentes a la zaga respecto al resto del grupo; el apoyo profesor-estudiante; conflictos familiares; e independencia familiar, así como la orientación de logros estuvieron vinculados a las TS en adolescentes. Los modelos también indicaron que el historial médico familiar fue el impacto más fuerte para las TS en adolescentes, a pesar de que las TS fueron prevalentes en las tres provincias chinas estudiadas. El género, edad, y las diferencias de vivienda fueron muy significativas en la tasas de SSS y TS positivas en adolescentes. Este estudio llega a la conclusión de que las TS adolescentes estaban influenciadas por múltiples entornos.
Subject(s)
Humans , Male , Female , Adolescent , Somatoform Disorders/epidemiology , Surveys and Questionnaires/statistics & numerical data , Environment , Anxiety/psychology , Anxiety/epidemiology , Rural Population/statistics & numerical data , Socioeconomic Factors , Somatoform Disorders/psychology , Random Allocation , Case-Control Studies , China/epidemiology , Sex Factors , Family Health/statistics & numerical data , Prevalence , Cross-Sectional Studies , Age Factors , Depression/psychology , Depression/epidemiology , Family SeparationABSTRACT
OBJECTIVE: To investigate the relationship of somatization and depression with the degree of lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH) and changes in psychometric profiles including somatization and depression after treatment of LUTS/BPH. METHODS: Subjects were evaluated at baseline and at week 12 following routine treatment for LUTS/BPH using the International Prostate Symptom Score (IPSS) to measure the severity of LUTS/BPH, the Overactive Bladder Symptom Score (OABSS) to measure the severity of OAB, the Patient Health Questionnaire-9 (PHQ-9) to assess depression, and the Patient Health Questionnaire-15 (PHQ-15) to evaluate somatization. The correlation of somatization and depression with the degree of LUTS/BPH symptoms at baseline and changes in somatization and depression after LUTS/BPH treatment were assessed using relevant statistical analyses. RESULTS: One hundred and twenty patients agreed to participate in this study, and 101 (84.2%) completed the 12-week trial and responded to the study questionnaires. At baseline, total IPSS score was correlated with PHQ-9 (r=0.475, p=0.005) and PHQ-15 (r=0.596, p<0.001) scores. The results after the 12-week treatment clearly show significant improvement in both PHQ-9 (p <0.001) and PHQ-15 (p=0.019) scores, and the PHQ-9 (r=0.509, p=0.048) and PHQ-15 (r=0.541, p=0.016) scores were positively correlated with total IPSS. CONCLUSION: Our preliminary results indicated that severity of LUTS is correlated with severity of somatization and depression. Further, the improvement of LUTS after treatment may have positive impacts on somatization and depression.
Subject(s)
Humans , Depression , Hyperplasia , Lower Urinary Tract Symptoms , Prostate , Prostatic Hyperplasia , Psychometrics , Somatoform Disorders , Treatment Outcome , Urinary Bladder, OveractiveABSTRACT
El objetivo del trabajo realizado fue evaluar la utilidad del Cuestionario de Salud del Paciente como posible instrumento de tamizaje para Trastornos por somatización. La metodología consistió en la validación de lenguaje del instrumento, mediante su traducción doble ciego. Posteriormente se realizó su validación de contenido con un panel de expertos. El cuestionario fue aplicado en una muestra aleatoria de100 personas en la atención primaria de salud del Hospital El Pino. Se aplicó de forma anónima y se excluyeron los síntomas de los pacientes producidos por enfermedades médicas ya diagnosticadas previamente. Al analizar los resultados se constató una sospecha de un 34,15 por ciento para trastornos por somatización según el cuestionario de salud del paciente, la cual sería 12 veces mayor a la indicada con los criterios del CIE-10 y casi 4 veces mayor que la indicada por los criterios de Escobar. Esto podría explicarse porque los síntomas pesquisados por el cuestionario se deban a otras enfermedades orgánicas o psiquiátricas, que no se discriminan bien por esta herramienta, o a errores en su aplicación.
The objective of the work performed was to evaluate the usefulness of the Patient Health Questionnaire as a possible somatization disorders screening tool. The methodology consisted in validating the language of the instrument, using a double blind translation. Then the questionnaire was presented to health professionals who gave us their impressions. The questionnaire was applied to a random sample of 100 people at the primary attention health service of Hospital El Pino. It was applied anonymously, and the symptoms of patients caused by medical diseases previously diagnosed were excluded. When the results were analyzed , a suspicion of 34.15 percent in somatization disorders was found according to the patient health questionnaire, which would be 12 times greater than that indicated in the criteria of the CIE-10, and almost 4 times greater than the one indicated by the criteria of Escobar. This could be explained if the symptoms investigated were caused by other organic or psychiatric diseases, that had not been discriminated by this tool or errors in its application.