“Baby I was born this way” is applicable to more than just Lady Gaga. It looks like this mantra extends to functional somatic symptoms (FSS) (J Pediatr 2013; 162: 335-42).
This study which was part of a longitudinal birth cohort study, Copenhagen Child Cohort CCC2000, included 6090 children born in a well-defined geographical area around Copenhagen, Denmark in 2000. At 5-7 year follow-up, a random sample of 3000 members of the cohort were selected; only 2912 were included as 79 were unreachable and 9 had died. Subsequently, 1327 had complete data and were the final study sample.
FSS were measured by the Soma Assessment Interview. In the first 10 months of living, regulatory problems which included at least 2 of 3 problems of feeding, sleeping, or tactile reactivity predicted impaired FSS at 5-7 years with aOR 2.9. Maternal psychiatric illness during the child’s first year of life conveyed an aOR of 7.1.
FSS (ie, headache and recurrent abdominal pain) could develop due to a number of possible mechanisms:
- hypersensitivity to stimuli
- autonomic hyper-reactivity
- regulatory problems may be risk factors for mood and anxiety disorders
While the strengths of this study included prospective data collection by health professionals and a fairly large sample size, there were still numerous limitations. Measuring regulatory problems in infancy is not fully validated. In addition, the designation of FSS is problematic as it is difficult to fully exclude organic etiologies which could present with similar complaints.
The association of maternal psychopathology with the development of FSS in their children is of interest. It is not clear if this risk is due to nurturing effects (i.e., child’s capacity to self-regulate) or due to nature (i.e., inherited susceptibility).