Association between somatic symptoms and depression and anxiety in adolescents: a cross-sectional school-based study.

BMJ Open

The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

Published: September 2025


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Article Abstract

Objectives: To explore the associations between somatic symptoms, depression and anxiety among Chinese adolescents in non-clinical settings.

Design: A cross-sectional study.

Setting: The questionnaire was distributed among Chinese students in Grades 10-11 from four vocational high schools (two in Anhui Province and two in Sichuan Province).

Participants: Across the four schools, 85 out of 4500 eligible students were excluded because of parental refusal, 296 students were excluded because they were absent from school during the survey time, and 4119 completed the questionnaire (38.29% females).

Primary Outcome Measures: Students' somatic symptoms, depression and anxiety were measured using the somatisation subscale of the Brief Symptom Inventory 18, the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder-7, respectively.

Results: After controlling for gender, age, family economic status, and paternal and maternal education level, compared with students without somatic symptoms, students with mild (OR=8.15; 95% CI=6.46 to 10.29), moderate (OR=18.78; 95% CI=13.08 to 26.96) and severe (OR=23.07; 95% CI=8.86 to 60.07) somatic symptoms reported significantly higher prevalence of depression; students with mild (OR=6.70; 95% CI=5.03 to 8.93), moderate (OR=16.41; 95% CI=11.38 to 23.67) and severe (OR=20.03; 95% CI=8.52 to 47.11) somatic symptoms reported significantly higher prevalence of anxiety.

Conclusion: The associations between somatic symptoms, depression and anxiety urge attention from caregivers and educators on young individuals experiencing somatic symptoms. Our findings highlight the potential predictive effects of somatic symptoms on depression and anxiety among Chinese students.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410616PMC
http://dx.doi.org/10.1136/bmjopen-2025-103860DOI Listing

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