Functional neurological symptom disorder (FNSD) is characterized by neurological symptoms that are unexplained by other traditional neurological or medical conditions. Both physicians and patients have limited understanding of FNSD, which is often explained as a physical manifestation of psychological distress. Recently, diagnostic criteria have shifted from requiring a preceding stressor to relying on positive symptoms. Given this shift, we have provided a review of the etiology of FNSD. Predisposing factors include trauma or psychi atric symptoms, somatic symptoms, illness exposure, symptom monitoring and neurobiological factors. Neurobiological research has indicated that patients with FNSD have a decreased sense of agency and abnormal attentional focus on the affected area, both of which are modulated by beliefs and expectations about illness. Sick role and secondary gain may reinforce and maintain FNSD. The integrated etiological summary model combines research from various fields and other recent etiological models to represent the current understanding of FNSD etiology. It discusses a potential causal mechanism and informs future research and treatment.

A systematic review was conducted using six databases from January 1, 2015 through March 9, 2018. We sought studies which looked at the relationship between sleep duration, sleep timing, or sleep quality and outcome variables of hypertension, inflammation, obesity, glucose or insulin, and lipids in children and adolescents. We found 24 studies which met our criteria. Nine studies included hypertension as an outcome variable; fifteen included obesity; thirteen included glucose or insulin; eight included lipids; and three included measures of inflammation. The existing literature on sleep and cardiovascular disease in children and adolescents is limited and relatively weak. Only one RCT was identified, and the overwhelming majority of studies had a high risk of bias. The strongest evidence of an association with sleep is with obesity, hypertension, and insulin sensitivity. Further research using more standardized methods and objective measures is needed to determine if a causal relationship truly exists between sleep and cardiovascular risk.

CPAP adherence appears to be associated with positive changes in OSAS-specific QoL domains. It will be important for future research and clinical work to examine strategies for improving CPAP adherence in youth with OSAS.

Objective Somatization and functional somatic symptoms reflect conditions in which physical symptoms are not sufficiently explained by medical conditions. Literature suggests that these somatic symptoms may be related to illness exposure in the family. Children with a parent or sibling with a chronic illness may be particularly vulnerable to developing somatic symptoms. This study provides a systematic review of the literature on somatic symptoms in children with a chronically ill family member. Methods A systematic review (PROSPERO registry ID: CRD42018092344) was conducted using six databases (PubMed, EMBASE, PsychINFO, Scopus, CINAHL, and Cochrane) from articles published before April 5, 2018. All authors evaluated articles by title and abstract, and then by full-text review. Relevant data were extracted by the first author and reviewed by remaining authors. Results Twenty-seven unique studies met the criteria. Seventeen examined somatic symptoms in children with a chronically ill parent, and seven evaluated somatic symptoms in children with a chronically ill sibling. Three studies examined somatic symptoms in children with an unspecified ill relative. The strongest relationship between child somatization and familial illness was found with children with a chronically ill parent (13/17 studies). Evidence for somatic symptoms in children with an ill sibling was mixed (4/7 studies found a positive association). Conclusions The literature on somatic symptoms in children suggests that parental illness is related to increased somatic symptoms in children. Research examining the effects of having a sibling with an illness on somatic symptoms is mixed. Several areas of future research are outlined to further clarify the relationship between familial chronic illness and somatic symptoms.