• Anders Hjern, Gösta Alfven, and Viveca Ostberg.
• Department of Children's and Women's Health, Uppsala University, Sweden. anders.hjern@socialstyrelsen.se
• Acta Paediatr. 2008 Jan 1; 97 (1): 112-7.

BackgroundThe proportion of Scandinavian school children reporting psychosomatic pain and psychological complaints have increased in recent decades. In this study we investigated these symptoms in relation to potential stressors in the school environment.MethodsA cross-sectional study was conducted based on child interviews linked to nationally representative household surveys in Sweden during 2002-2003 covering a sample of 2588 children aged 10-18 years. The main outcome variable of psychosomatic pain signified suffering from headache as well as recurrent abdominal pain on a weekly basis.ResultsSchool stressors, such as harassment by peers, schoolwork pressure and being treated poorly by teachers, were associated with psychosomatic pain as well as psychological complaints such as sadness, irritability, feeling unsafe and nervous. Harassment was identified as a particularly important determinant with adjusted odds ratios (ORs) ranging from 3.1 to 8.6 for psychosomatic pain. All psychological complaints were associated with psychosomatic pain with adjusted ORs ranging from 2.2 to 3.7, and mediated most of the association of harassment to psychosomatic pain.ConclusionsSchool stressors are strongly associated with psychosomatic pain and psychological complaints in school children. Psychological complaints seem to function as mediators in the association of school stressors to psychosomatic pain symptoms to a great extent.

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