Childhood risk factors for adults with medically unexplained symptoms: results from a national birth cohort study

Am J Psychiatry. 1999 Nov;156(11):1796-800. doi: 10.1176/ajp.156.11.1796.


Objective: The purpose of this study was to test the hypothesis that the prior experience of physical illness in childhood is associated with later experience of medically unexplained symptoms.

Method: A nested case-control study was performed within a prospective birth cohort study: the Medical Research Council National Survey of Health and Development. The 5% most symptomatic individuals at age 36 years were identified and screened for physical illness. Subjects without defined physical diagnoses (N = 191) were compared with the remainder of the sample (N = 3,107) for childhood exposures.

Results: There was a powerful relationship between poor reported health of the parents when subjects were aged 15 years and symptoms at age 36; the relationship was independent of current psychiatric disorder. Medically unexplained symptoms were associated with abdominal pain in childhood but not with defined childhood diseases.

Conclusions: Medically unexplained symptoms appear to be related to prior experience of illness in the family and previous unexplained symptoms in the individual. This may reflect a learned process whereby illness experience leads to symptom monitoring.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Child Development*
  • Cohort Studies
  • Family Health*
  • Female
  • Health Status*
  • Health Surveys
  • Humans
  • Male
  • Parents / psychology
  • Pregnancy
  • Risk Factors
  • Sick Role
  • Social Class
  • Somatoform Disorders / epidemiology*
  • Somatoform Disorders / psychology