Mapping the network structure of dysmenorrhea-related somatic symptoms and their determinants among adolescents

This study investigated factors associated with dysmenorrhea-related somatic symptoms in adolescent girls, stratified by self-reported mental disorder diagnoses. This cross-sectional study included 1,529 Chinese female students aged 10 to 19 years from middle and secondary schools. A self-reported questionnaire was used to assess the multidimensional manifestations of dysmenorrhea-related somatic symptoms, menstrual characteristics, and psychological and behavioral factors. Network analysis was used to examine interrelationships among somatic symptoms and their correlates in adolescent girls with and without self-reported mental disorder diagnoses. Of the 1,529 girls, 162 (10.6%) reported a history of at least one mental disorder diagnosis. Among adolescent girls with self-reported mental disorder diagnoses, back/leg pain and dizziness had the highest strength centrality. The presence of dysmenorrhea-related somatic symptoms showed conditional associations with the frequency of dysmenorrhea, anxiety, depression, disappointment, analgesic use, and thermal therapy. Among girls without a mental disorder diagnosis, dizziness and nausea had the highest strength centrality. The severity of dysmenorrhea, hormonal medication use, anxiety, and depressive symptoms were associated with the overall somatic-symptom node. The frequency and severity of dysmenorrhea also showed conditional associations with specific somatic symptoms. For those with mental disorder diagnoses, thermal therapy and analgesic use were associated with most somatic symptoms. Self-reported anxiety and depressive symptoms were associated with dysmenorrhea-related somatic symptoms. Thermal therapy and analgesic use were also associated with dysmenorrhea frequency and pain severity among adolescents with self-reported mental disorder diagnoses. Future longitudinal studies are needed to clarify the relationships among psychological distress, coping behaviors, and dysmenorrhea.