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

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.

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.

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.

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.