Anxiety Disorders And Unexplained Somatic Symptoms In Youths Admitted At The Emergency Room: The Smile Experience

ObjectivesAdolescence is the highest risk period for anxiety disorder (AD). The clinical manifestations of AD in adolescence are mainly somatic, although adolescents manifest also fear to denth and fear of loss control. In 50-65% of patients with diagnosis of panic disorder, depressive symptoms precede the onset of ADs. Moreover, in youths, a strong association was found between alcohol use and abuse and mood disorders. The aim of this study was to estimate the presence of anxious and depressive symptoms in a young sample with somatic unexplainable symptoms. Furthermore, we aimed to investigate the correlations among physical symptoms, visits to the specialist and diagnostic examinations, and anxious and depression symptoms. Finally, we investigated the use of alcoholic substances in this population.MethodsThe study has been carried out on 50 young patients admitted consecutively at the Emergency Room (ER) of the L'Aquila Hospital for the onset of unexplained somatic symptoms. A sample of subjects from the Sports Medicine Unit of L'Aquila Hospital was the control sample (Table I). All subjects underwent the following standardized screening tests: Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), State-Trait Anxiety Inventory Y2 (STAI-Y2) and CAGE.ResultsThe clinical sample showed a higher frequency of e unexplained somatic symptoms than the control sample except for the "sweat", the "derealization feelings" and the "fear to lose the control" (Table II). The clinical sample, moreover, differed from the control sample for the number of somatic symptoms, the number of specialist visits and diagnostic examinations (Tables III, IV). The clinical sample scored higher on the SAS, SDS and STAI-Y2 scales than controls (Table VI). The use of alcoholic substances were more widespread in the clinical sample. Significant correlations were obtained among the above variables.ConclusionsIn most subjects with prevalent somatic symptoms, psychiatric symptomatology is not given due consideration, with ensuing misdiagnosis and inadequate treatment. This is important for adolescents and young people because ADs are considered as an important risk factor for the future development of severe mental disorders, for comorbidity with substance use disorder and poor psychosocial function and quality of life. Our experience, moreover, confirms the need to screen youths so to establish adequate treatment and to avoid symptom worsening and related complications.