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Saturday, February 11, 2012

Psychosomatic problems in abused children

In a Swedish study on the connection between somatic issues with children, there was a clear link between these and children who were physically abused. It was more evident when they also witnessed inter personal violence (IPV) on top of the physical abuse. It is of some interest that the issues did not seem to arise from IPV witnessing on its own. The studies results of looking at over 2500 students aged 10, 12 and 15 in 44 different schools showed:

  • One in six of the children (16%) had suffered physical abuse or witnessed IPV in the home -- 9% reported just physical abuse, 4% reported IPV alone and 3% reported both.
  • Two-thirds of the children (66%) reported at least one psychosomatic symptom and just over a third of these children (35%) reported three symptoms or more.
  • The most common symptoms were headache (38%), sleeplessness (36%) and stomach ache (31%).
  • 86% of the children who reported that they were physically abused and had witnessed IPV at home reported at least one psychosomatic symptom, with 41% reporting three or more, compared with 17% of the non-abused children.
  • 82% of the children who reported physical abuse only reported at least one symptom, with 35% reporting three or more symptoms compared with 17% of the non-abused children.
  • There was no significant difference in the symptoms reported by children who did or did not report just IPV.
  • When confounding factors, such as chronic conditions, bullying and school performance were taken into account, the odds of a child suffering physical abuse, with or without IPV, was 112% higher (OR 2.12) than a child who was not being abused. When IPV was added into the equation, this rose to 171% higher (OR 2.71)
  • The odds for a child suffering physical abuse only was 72% higher (OR 1.72) and the odds for IPV only was 9% higher (OR 1.09).
  • Abused children with chronic conditions reported significantly more psychosomatic symptoms than abused children without chronic conditions.
This study echoes previous research that has seen a link between abuse and physical symptom presentation. A Toronto study published in 2011 found a link between child abuse and peptic ulcers in adulthood.

In 2010, researchers in the United States concluded:

Children who have been abused psychologically, physically or sexually are more likely to suffer unexplained abdominal pain and nausea or vomiting than children who have not been abused, a study led by University of North Carolina at Chapel Hill researchers concludes.

All of this suggests, of course, that when we see children or adults who present with physical symptoms that may be more somatic in their origins, we should be asking about abuse experiences.


Carolina Jernbro, Birgitta Svensson, Ylva Tindberg, Staffan Janson. Multiple psychosomatic symptoms can indicate child physical abuse - results from a study of Swedish schoolchildrenActa Paediatrica, 2012; 101 (3): 324 DOI:10.1111/j.1651-2227.2011.02518.x

E. Fuller-Thomson, J. Bottoms, S. Brennenstuhl, M. Hurd.Is Childhood Physical Abuse Associated With Peptic Ulcer Disease? Findings From a Population-Based StudyJournal of Interpersonal Violence, 2011; DOI:10.1177/0886260510393007

University of North Carolina School of Medicine (2010, March 8). Abused children more likely to suffer unexplained abdominal pain, nausea or vomiting. ScienceDaily. Retrieved February 11, 2012, from­/releases/2010/03/100308170957.htm

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