School Absenteeism as a Perpetuating Factor of Functional Somatic Symptoms in Adolescents: The TRAILS Study

Objective To examine whether school absenteeism is a perpetuating factor of functional somatic symptoms and whether this holds true for bullied adolescents. Study design This study is part of the longitudinal population-based study Tracking Adolescents' Individual Lives Survey. Data from assessment wave 2 (n = 2149; 51.0% girls; mean age = 13.65, SD = 0.53) and assessment wave 3 (n = 1816; 53.3% girls; mean age = 16.25, SD = 0.72) were used. Peer victimization was assessed by peer nominations, school absenteeism by both parent and teacher reports, and functional somatic symptoms with the Youth Self-Report. Results With structural equation modeling, school absenteeism at the second wave, adjusted for functional somatic symptoms at the second wave, was revealed to predict functional somatic symptoms at the third wave in the entire cohort (beta = 0.12; 95% CI, 0.02-0.22), but not in the subgroup of bullied adolescents (beta = -0.13; 95% CI, -0.62--0.26). However, the difference between bullied and unbullied adolescents did not reach significance. Conclusion This study provides evidence that school absenteeism is a perpetuating factor of functional somatic symptoms in adolescents. A clinical intervention study is necessary to examine whether preventing school absenteeism truly helps to reduce functional somatic symptoms in adolescents. (J Pediatr 2011;159:988-93)