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Despite findings from previous studies, there is still little consistent knowledge regarding the co-occurrence patterns of somatic, depressive and anxiety symptoms in childhood and adolescence. Moreover, functional disability due to somatic symptoms at different concomitant levels of depression and anxiety is understudied. The present study examined the co-occurrence patterns of somatic symptoms and symptoms of depression and anxiety, in children and adolescents using two-step cluster analysis. Differences in functional disability due to somatic symptoms were tested with ANCOVA controlling for gender and age. The sample comprised 1127 Italian children and adolescents (48.7% males, n = 549) aged 8–16 years (Mage = 11.7, SD = 2.37). Data were collected using the Children Somatization Inventory-24, the Children Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders, and the Functional Disability Inventory. A four-cluster solution based on the co-occurrence of internalizing symptoms best fit the data. The four clusters were labelled as follows: cluster 1: “High somatic symptoms and average depression/anxiety”; cluster 2: “High somatic symptoms and high depression/anxiety”; cluster 3: “Average somatic symptoms and above average depression/anxiety”; and cluster 4: “Low somatic symptoms and low depression/anxiety”. Significant differences between the four groups according to gender and age were shown. Participants with high levels of somatic, depressive, and anxiety symptoms reported greater functional disability due to somatic symptoms than the other three groups. Our findings indicate that children and adolescents who demonstrate high symptoms of depression and anxiety also reported higher levels of disability in daily life due to somatic symptoms.

Psychological distress represents a longstanding issue that has been observed in university student populations. The present study aimed to explore the psychological distress in a group of university students seeking for psychological help available in an Italian University Counselling Service. Participants were 597 students (70.5% female, Mage = 24.79, SDage = 5.08) who consulted the Psychological Service at the University and completed the Adult Self-Report (ASR) questionnaire prior to a brief psychodynamic intervention (T1) and 372 of them (70.4% females, Mage = 24.85, SDage = 5.44) were re-evaluated on the same scales three months after the end of the intervention within a follow-up session. Findings demonstrated that students who dropped out at follow-up had slightly higher baseline scores in Thought Problems and Rule-Breaking Behavior. Adopting a Latent Change Score Difference (LDS) approach to model the differences between T1 and T2 scores in ASR scales, results showed an average significant and reliable decrease in all psychopathological syndromes, although the rate of this change was not uniform for all individuals (in the case of somatic complaints, this was partially accounted for by gender). Students reporting higher symptoms in three syndromes at T1 (i.e., somatic complaints, depressive symptoms, withdrawal) showed a steeper decrease of such scores at the follow-up. Findings suggest that a short-term psychological counselling intervention may represent an efficacious way to deal with emerging psychopathological distress within university contexts.

The association among alexithymia, somatic symptoms and clinical correlates has been scantly investigated in children. The present study examined alexithymic features and somatic symptomatology in schoolchildren with high and low levels of depression, testing the role of depressive symptoms in mediating the associations between alexithymia and somatic symptoms. Seven-hundred schoolchildren were involved in this study and divided into two subgroups (8-10 years and 11-14 years) in order to test differences according to the age. Participants completed the Children's Somatization Inventory-24 for the assessment of somatic symptoms, the Alexithymia Questionnaire for Children to evaluate alexithymic features and the Children's Depression Inventory-2 to investigate depressive symptoms. Results showed that children with high levels of depression reported both higher alexithymia and somatic symptoms levels. Despite a direct effect of alexithymia on somatic symptoms, the mediation analyses also highlighted an indirect effect of alexythimia on somatic symptoms through depressive symptoms. Findings suggested that a depressive symptomatology may clarify why schoolchildren with high alexithymia scores tend to report higher levels of health problems. Results also support the possibility that depressive symptoms may contribute to the development of somatic symptomatology among schoolchildren in the presence of high levels of alexithymia.

Migraine is one of the most frequent complaints in children and adolescents and it can have a significant impact on quality of life. There are several factors underlying the onset and the maintenance of this disorder and there is still no a clear etiopathogenesis common to all subjects suffering from migraine. Psychological factors such as individual characteristics, psychiatric comorbidities, and temperament are strictly related to psychosomatic disorders and to migraine. Also, the environmental influence is very relevant and studied: socio-economic status, family dysfunctions, attachment style, or psychiatric disease in parents can influence the onset of migraine in children. Finally, many studies are trying to find out any alteration in genetics or in cerebral areas or networks that can explain migraine vulnerability. In this review, we analyze the most recent findings on neurological, psychological, and environmental factors that may potentially cause migraine.

Chronic daily headache (CDH) in children and adolescents presents features not sufficiently recognized by the current classification system. The aim of our study was to analyze the applicability of adult CDH classification in child and adolescent clinical populations, outlining similarities and differences. In the developmental age, frequent and severe migraine attacks may overlap daily crises of tension-type headache. The clinical onset features are similar to the subsequent (chronic) trend, while in adults, it is more typical that migraine changes over time, taking tension features with almost daily crises. Headache with onset in children or adolescents presents age-related characteristics and the classification system should be better tailored to the peculiarities of this clinical phenomenology. Having a strong diagnostic system is the sine qua non of further investigations in epidemiology, etiopathogenesis, and therapy of CDH.