A somaticizing adolescent: an approach to evaluation and therapy (original) (raw)

Somatization Disorders in Children and Adolescents

Pediatrics in Review, 2003

Objectives After completing this article, readers should be able to: 1. Describe the various manifestations of somatization disorders in children and adolescents. 2. Delineate the association of psychosomatic disorders with stress, parental anxiety, or pressure for a child to perform. 3. Distinguish between primary and secondary gain. 4. Explain why school attendance should be assessed with every recurrent complaint. 5. Explain why pediatricians should establish a partnership with patients and their parents when addressing their symptoms. 6. Develop a cost-effective investigation of suspected somatoform disorders and an approach to insurance companies regarding reimbursement of services.

Somatization disorders: diagnosis, treatment, and prognosis

Pediatrics in review / American Academy of Pediatrics, 2011

Objectives After completing this article, readers should be able to: 1. Identify the various manifestations of somatization disorders in children and adolescents. 2. Understand the association of psychosomatic disorders with personality traits and stressors such as physical and sexual abuse, bullying, parental anxiety, and pressure for a child to perform. 3. Recognize secondary gains of somatization disorders. 4. Explain why it is necessary to focus on school attendance and the management of school avoidance. 5. Develop a partnership with patients and their parents to address the symptoms of a somatization disorder. 6. Plan the treatment and management of somatization disorders

Somatization disorder in young adult population

General Hospital Psychiatry, 2004

Somatization is a widespread problem in health care. We estimated the occurrence of Somatization Disorder (SD) using three different case-finding methods in a general population cohort. The sample consists of 1,598 subjects born in 1966. The case-finding methods according to the DSM-III-R criteria for SD were: 1) Finnish Hospital Discharge Register (FHDR) data, 2) analysis of the patient records in public outpatient care 1982-1997, and 3) Structured Clinical Interview for DSM-III-R (SCID) for 321 selected cases. The prevalence of SD was 1.1% , giving a female-to-male ratio of 5:1. All cases were found among the public outpatient care records. No cases appeared in the FHDR or were recognized in the psychiatric interview. The lifetime prevalence of SD was comparable with previous western population studies. Methodologically, information from outpatient records may be more sensitive in detecting SD than hospital diagnosis or even psychiatric interview. Clinically we stress the importance of recognizing these cases by liaison psychiatrists especially because SD has been recognized as being difficult to treat among somatic and primary health service providers and because some promising treatment alternatives such as cognitive-behavioral therapy and antidepressants have emerged for SD patients.

Somatization in Children and Adolescents: Practical implications

Somatization is the propensity to experience and report psychological and/or emotional suffering through physical symptoms that cannot be explained by known medical causes. Somatic complaints are often a result of an impaired ability to verbalize emotional distress, and are commonly encountered in children and adolescents. Children report a diversity of somatic problems, including headache, stomachache, dizziness, and lethargy. Several factors contribute to the display of somatic complaints, such as a family history of health problems, parental modeling and reinforcement of illness behavior, temperament, psychological processes, gender, and cultural emotion socialization influences. In this review, we define somatic symptom clusters, and report the frequency of somatic problems in children and adolescents. Second, we discuss biological and environmental influences that contribute to somatization in children and youth. Third, we 80 discuss gender differences and cultural factors related to somatic complaints in childhood. Finally, possible cognitive interventions (such as guided imagery, mindfulness training, and relaxation), and recommendations for practitioners dealing with children with somatic complaints in schools are discussed.

Somatoform Disorders in Children and adolescents

Somatoform disorders remain one of the most neglected areas in child and adolescent psychiatry. Somatoform disorders among children and adolescents cause impairment in educational and social functioning and generate a great deal of psychosocial distress. Patients with these disorders typically present to general medical settings rather than to mental health settings. Early referral to mental health professional is required to avoid unnecessary investigations and delay in diagnosis of somatoform disorders in children (German J Psychiatry 2014; 17(1): 19-24).

Prevalence, comorbidity and psychosocial impairment of somatoform disorders in adolescents

Psychology Health & Medicine, 1999

A bstract T he frequency, com orbidity and psychosocial impairm ent of som atoform disorders am ong adolescents was estimated from a survey of 1,035 students aged 12± 17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germ any. Som atoform disorders and other psychiatric disorders were assessed using the com puterized M unich version of the Composite International D iagnostic Interview (C ID I). About 13.1% of the adolescents m et the D SM-IV criteria for any somatoform disorders, with signi® cantly more girls than boys being affected by these disorders. Of the sub-types of somatoform disorders, the most com mon was that of undifferentiated somatoform disorders, followed by pain disorder, and conversion disorder. O n the symptom level, the m ost com mon were headache, lum p in throat, and abdominal pain. Almost half of those with somatoform disorders met the criteria for at least one other disorder covered in our study. Although m ost of these adolescents were psychosocially im paired, only a small proportion of them did receive treatment.

Somatic Symptoms in Children and Adolescents Referred for Emotional and Behavioral Disorders

Psychiatry, 2000

MEDICALLY unexplained physical symptoms are frequently endorsed by children and adolescents in both clinical and community samples. The aim of this exploratory study is to examine the prevalence of somatic symptoms in a sample of 162 Italian children and adolescents consecutively referred to a Division of Child Neurology and Psychiatry from emotional and/or behavioral disorders. The role of age, gender, and psychiatric status was considered as a variable. Each patient received a DSM-N assessment, including a diagnostic structured interview (DICA-R). The sample was divided according to gender (96 males, 66 females), age (70 children younger and 92 adolescents older than 12 years), and psychiatric diagnosis (Anxiety, Depression, Depression! Anxiety, Other). The presence of medically unexplained somatic symptoms was based on the responses to the DICA-R. Somatic complaints were reported in 69.2% of the patients. Headache was the most frequent somatic symptom (50.6%). Younger children showed higher rates of abdominal complaints than adolescents. No gender differences in frequency of somatic complaints were reported. Subjects with anxiety and/or depression reported significantly higher rates of somatic complaints, namely headache, than subjects with other mental disorders. No differences in frequency of somatic symptoms were evident between patients with anxiety, depression, and comorbid anxiety-depression. Our data suggest that an unexplained somatic symptom can be often considered as indicative of a neglected anxiety and/or depressive disorder. A collaboration between primary care physicians, pediatricians, and child psychiatrists may promote early diagnoses and timely treatments and prevent negative social and scholastic consequences.