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. 2025 Jul 16;24(1):45.
doi: 10.1186/s12991-025-00582-w.

Prevalence and associated factors of somatic symptoms among adolescents in Singapore: a cross-sectional study

Dhiya Mahirah  1   2 , Jane Mingjie Lim  3 , Mary Su-Lynn Chew  4 , Nidhi Peddapalli  4 , Clement Zhong-Hao Ho  4 , Vicknesan Jeyan Marimuttu  4   5 , Helen Yu Chen  5 , Sharon Cohan Sung  4   5   6 , Yi-Ching Lynn Ho  4 , Cheryl Bee-Lock Loh  7
Affiliations

Prevalence and associated factors of somatic symptoms among adolescents in Singapore: a cross-sectional study

Dhiya Mahirah et al. Ann Gen Psychiatry. .

Abstract

Background: Somatic symptoms are physical symptoms that often arise in response to emotional distress and can significantly impact well-being. Understanding the prevalence and interplay of these symptoms with anxiety and depression is crucial for understanding adolescent health outcomes in Singapore. This study aimed to determine the prevalence of somatic symptoms among adolescents in Singapore and examine their associations with demographic characteristics, life stressors, anxiety, and depression.

Methods: We conducted a cross-sectional online survey with 601 Singaporean adolescents aged 12 to 19, using the Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptoms Scales (PHQ-SADS) to assess somatic symptoms, anxiety, and depression levels. Demographic information and experiences with stressful life events were also collected. Both descriptive and regression analyses were used to understand the relationships between participants' sociodemographic factors, mental health symptoms, and the presence of somatic symptoms.

Results: 32.3% of the adolescents reported clinically significant levels of somatic symptoms, with a higher prevalence observed among those who were females and older. While no significant associations were found between somatic symptoms and demographic factors, adolescents with anxiety or depressive symptoms presented significantly increased odds of reporting somatic symptoms. Specifically, the odds of reporting somatic symptoms were 2.91 times greater for those with anxiety (95%CI: 1.55-5.45, p < 0.001) and 6.54 times greater for those with depression (95%CI: 3.75-11.6, p < 0.001) than for those without these mental health concerns. Furthermore, those with somatic symptoms reported a greater number of stressful life events, with academic pressure emerging as the most prominent stressor.

Conclusions: This study highlights the prevalence of somatic symptoms among adolescents in Singapore, emphasising the interconnectedness of mental and physical health during this developmental stage. The strong associations between somatic symptoms, anxiety, depression, and life stressors underscore the need for a holistic approach to adolescent healthcare. Early identification and intervention strategies should focus on addressing mental health concerns, building resilience against stressors, and promoting healthy coping mechanisms to mitigate the burden of somatic symptoms and foster overall well-being in Singaporean adolescents.

Keywords: Adolescent mental health; Anxiety; Depression; Life stressors; Singapore; Somatic symptoms.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Studies involving human participants were reviewed and approved by the SingHealth Centralised Institutional Review Board (CIRB; reference number: 2023/2508). Written informed consent was not required to participate in this study in accordance with the national legislation and institutional requirements. Competing interests: The authors declare no competing interests. Consent for publication: Not applicable.

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