Explanations for female excess psychosomatic symptoms in adolescence: evidence from a school-based cohort in the West of Scotland

A cohort of 2,196 school pupils (analyses restricted to 2,005 with complete data) surveyed at age 15. All measures were obtained via self-completion questionnaires, apart from body mass index, derived from measured height and weight. Analyses examined (a) sex differences in each potential explanatory factor; (b) their associations with the health measures; (c) the effect of adjustment for these factors on sex differences in the health measures; and (d) the existence of interactive effects between sex and the explanatory factors on the health measuresEach potential explanatory factor was significantly differentiated by sex. Self-esteem, body image (represented by weight-related worries), smoking and physical activity were related to the health measures. These factors accounted for one third of the female excess in headaches and stomach problems, half the excess in dizziness and almost all that in respect of depressive mood. Self-esteem and body image were the factors most consistently related to health, and adjustment for these resulted in the largest reductions in the odds of a female excess in both the psychosomatic symptoms and depressive mood.Adjustment for a range of potential psychosocial and behavioural factors largely explains (statistically) excess female depressive mood. These factors also partially explain the female excess in certain psychosomatic symptoms.The emergence of higher rates of psychological distress among females in early-mid adolescence is well documented [1-3], one study showing a consistent pattern in the onset of excess depression among females at age 14 across three Western countries, irrespective of how measured [4]. Other studies have found a similar pattern for chronic illness, self-reported health, physical and/or psychosomatic symptoms [5-8]. Thus, in previous analyses, based on the dataset employed in this paper, we showed that generally high levels of self-reported morbidity tended to increase between ages 11 and 15, these increase