Variations in Patterns of Somatic Symptoms Associated With Depression in Children From Three Caribbean and Latin American Countries
Roger C. Gibson, Gillian A. Lowe, Mia A. Jules, Avril Daley, Kelly Romero-AcostaBackground
Identifying specific patterns of somatic expressions of depression among children from Global South countries may help inform health promotion, screening, referral pathways, assessments and interventions in various contexts (e.g., schools and clinics).
Method
1541 children from Barbados, Colombia and Jamaica completed the Adolescent Depression Rating Scale (ADRS) and the Children’s Somatization Iventory-24 (CSI-24). For each country, item discrimination indices (IDIs) were calculated for each item of the CSI-24 to determine which items best identified persons with the highest depression scores. Scales consisting of the six CSI-24 items with the highest IDIs in each country were then created and assessed for their association with clinically significant depression using regression analyses.
Results
The CSI-24 items with the highest IDIs were different for each country, but with physically restrictive somatic symptoms being consistently prominent. The country-specific six-item somatic subscales were significant predictors of depression, with odds ratios (95% CI) of 1.56 (1.41, 1.73), 1.29 (1.21, 1.37) and 1.24 (1.15, 1.35) for Colombia, Jamaica and Barbados respectively.
Conclusions
“Difficulty moving forward” was symbolically represented in the restrictive somatic symptoms with high IDIs. The different findings among countries may reflect unidentified cultural nuances. Depression screening strategies that consider relevant somatic symptoms could be valuable.