Co-occurrence of depressive, anxiety, and somatic symptoms : trajectories from adolescence to midlife using group-based joint trajectory analysis

Background: Co-occurrence of mental and somatic symptoms is common, and recent longitudinal studies have identified single trajectories of these symptoms, but it is poorly known whether the symptom trajectories can also co-occur and change across the lifespan. We aimed to examine co-occurring symptoms and their joint trajectories from adolescence to midlife. Methods: Longitudinal data were derived from Northern Sweden, where 506 girls and 577 boys aged 16years participated at baseline in 1981 (99.7% of those initially invited), and have been followed up in four waves until the age of 43. Survey data were collected about depressive, anxiety, and somatic symptoms. Potential joint development of this three-component symptom set was examined with multiple response trajectory analysis, a method that has not been previously used to study co-occurrence of these symptoms. Results: We identified a five trajectory solution as the best: very low (19%), low (31%), high (22%), late sharply increasing (16%) and a very high increasing (12%). In the late sharply increasing and very high increasing groups the scores tended to increase with age, while in the other groups the levels were more stable. Overall, the results indicated that depressive, anxiety, and somatic symptoms co-exist from adolescence to midlife. Conclusions: The multiple response trajectory analysis confirmed high stability in the co-occurrence of depressive, anxiety, and somatic symptoms from adolescence to midlife. Clinicians should consider these findings to detect symptoms in their earliest phase in order to prevent the development of co-occurring high levels of symptoms