Aims: This study investigates the association between psychosomatic complaints ( PSC) and background factors from children in the five Nordic countries, their families, and their social context in a model using proximal ( child) , intermediate ( family) , and distal ( society) levels. Similarities and differences between the countries were compared. Methods: A questionnaire was sent to the parents of a representative sample of 3,760 Nordic children aged seven to 12 years. The relationship between PSC and background factors was analysed using structural equation modelling. Results: Headaches and stomach complaints were most common. The prevalence was higher in girls than in boys. A LISREL analysis showed that determinants of PSC varied little between countries. The most important factors associated with PSC were the mother's health and well-being, the child's mental stability and social competence, and the family's socioeconomic status. Families with low education, blue-collar work, low income, and unemployed fathers were found to be most vulnerable . High risk factors could be infl uenced by other intervening protective factors. The greatest country differences were found on the distal level, where macroeconomic, legislative, and social factors dominated . Conclusions: The pattern of PSC was quite similar between the Nordic countries, although there were some small differences. The results also confirm that the determinants of PSC are multidimensional . Longitudinal studies are needed to clarify the complex reality.
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