Characteristics of Medically Hospitalized Pediatric Patients With Somatoform Diagnoses

Abstract

Clarifying the prevalence and nature of such characteristics can help pediatric providers improve patient care and minimize unnecessary medical interventions with early detection of risk for somatoform processes, provision of psychoeducation for patients and families, and early referral to mental health clinicians.

Medically Hospitalized Patients With Eating Disorders and Somatoform Disorders in Pediatrics: What Are Their Similarities and Differences and How Can We Improve Their Care?

“…27 The current study was conducted at a facility with a wide catchment area across multiple states, and therefore, our income findings are less likely to be solely due to geographic location; factors related to the pediatric age group, treatment setting (ie, inpatient versus community), and/or the disorders themselves likely also play a contributory role. Specifically, existing research indicates that pediatric patients with SFD who are medically hospitalized in a tertiary hospital setting in the United States come from families with above-average household incomes 6 and that anorexia nervosa is more common among families of high socioeconomic status. 28 Recent studies on youth from affluent communities highlight certain vulnerabilities in this group, with perceived parental/societal pressures to achieve academically and/or in extracurricular activities resulting in poor adolescent adjustment and psychological difficulties.…”

“…4 Similarly, patients with somatoform disorders (SFD) are at risk for frequent hospitalizations because of their physical symptoms and place a significant burden on the health care delivery system, with twice the inpatient medical care use and twice the medical care costs of nonsomatizing patients. 5 Patients with SFD constituted 13% of medically hospitalized youth seen by an inpatient psychiatric consultation service at a free-standing children' s hospital in 2010 and 2011 6 and were the third most common referral (anxiety and depressive diagnoses being the most common). 7 Admission to the hospital is associated with greater functional impairment compared with the outpatient setting, 4,6 and inpatient pediatric mental health has been identified as a priority area for national quality measurement and improvement.…”

“…5 Patients with SFD constituted 13% of medically hospitalized youth seen by an inpatient psychiatric consultation service at a free-standing children' s hospital in 2010 and 2011 6 and were the third most common referral (anxiety and depressive diagnoses being the most common). 7 Admission to the hospital is associated with greater functional impairment compared with the outpatient setting, 4,6 and inpatient pediatric mental health has been identified as a priority area for national quality measurement and improvement. 1,8 Understanding the characteristics of patients with primary psychiatric disorders like ED and SFD, who are often medically hospitalized in pediatric settings, is the first step toward establishing foundational knowledge to guide future quality improvement and integrated care efforts.…”

“…Although it is well documented that patients with ED and SFD have higher rates of health care use across multiple health care settings compared with the general population 5,9 and that psychological factors, such as denial, poor motivation, alexithymia (ie, difficulty identifying and verbally expressing feelings), and limited insight affect their health care use, [10][11][12][13] it is not known if they use services with the same rates and patterns. Furthermore, although other similarities can be gleaned from separate studies of patients with ED and patients with SFD (eg, female preponderance, 6,14 age of presentation in adolescence, 4,6 increased risk of ED and SFD in the offspring of parents with anxiety and depressive disorders 15,16 ), it remains unclear how much biopsychosocial characteristics overlap between these 2 patient groups. As such, the current study aims to describe the demographic and clinical characteristics and health care use of medically admitted children, adolescents, and young adults with ED and SFD at a tertiary teaching pediatric facility.…”

Validity and Reliability of the Turkish Version of DSM-5 Level 2 Somatic Symptom Scale (Child Form for 11-17 Years and Parent Form for 6-17 Years)

“…5,9 ABD'de yapılan bir çalışmada somatizasyon bozukluğu tanısı konan olguların %60'ına eş psikiyatrik tanı konduğu, en sık anksiyete bozukluğunun (%42) eşlik ettiği belirtilmiştir. 10 Türki-ye'de yapılan bir çalışmada, çocuk ve gençlerde somatizasyon bozukluklarının %15.7 oranında majör depresyon ve %37.2 oranında anksiyete bozukluğu ile birliktelik gösterdiği saptanmıştır. 11 Anksiyete bozuklukları da somatizasyonla ilişkili-dir.…”