Understanding co-occurring somatic and psychological symptoms: A network comparison between Irish and Hong Kong...

Somatic and psychological symptoms frequently co-occur in adolescence, yet little is known about their symptom-level interconnections and potential cultural differences. This study employed a network approach to examine interconnections among somatic and psychological symptoms, identify central and bridge symptoms, and compare network patterns across 6037 adolescents in Hong Kong, China (HKC, a bicultural region with Chinese heritage and British influence; 48.94% girls; M_age = 15.56 years) and 5577 in Ireland (a representative Western culture; 49.79% girls; M_age = 15.56 years). Results revealed that dizziness and difficulties in getting to sleep consistently emerged as bridge symptoms in both groups, underscoring their pivotal role in the co-occurrence of somatic and psychological symptoms. Dizziness and feeling depressed were central in both groups, while feeling nervous emerged as an additional central symptom among HKC (vs Irish) adolescents, suggesting the cultural salience of anxiety-related experiences in Hong Kong's bicultural context. These symptoms highlight targets for intervention aimed at promoting adolescent well-being. Cross-cultural comparisons further revealed distinct patterns of network connectivity. Specifically, HKC adolescents exhibited denser within-domain associations compared with Irish adolescents. In contrast, Irish (vs HKC) adolescents displayed denser cross-domain (somatic-psychological) associations. These findings suggest that interventions should be adapted to different cultures. For HKC adolescents, attention needs to be paid to the risk that symptoms in one domain may exacerbate similar discomforts within the same domain; for Irish adolescents, efforts in lowering symptoms in one domain may more effectively translate into improvements in another domain.