Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms

Chun, Thomas H.; Mace, Sharon E.; Katz, Emily

doi:10.1542/peds.2016-1573

Cited by 22 publications

(18 citation statements)

References 146 publications

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“…According to recent scienti c publications, clinical practices can improve the clinical outcome of patients (32). Despite the studies on SSD patients, who deal with their recognition and management inside and outside the hospital, there are no speci c guidelines available to approach them at the ED (7,13,27,33). We believe this clinical practice can help appropriately recognize and appropriately manage these patients, outlining the necessary steps needed in ED.…”

Section: Discussionmentioning

confidence: 99%

“…When symptoms last for a long time, without any red ag of an organic disease, with repeated diagnostic work-up already performed and with an unremarkable physical examination, the diagnosis of a previously unrecognized organic disease is highly unlikely. SSD's primary differential diagnoses are factitious disorder and factitious disorder imposed by the caregiver (6,7,15,18,19).…”

Section: Differential Diagnosismentioning

confidence: 99%

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How to Recognize and Manage Psychosomatic Pain in the Pediatric Emergency Department

Cozzi

Lucarelli

Borrometi³

et al. 2021

Preprint

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Aim: Children and adolescents affected by somatization and somatic symptom disorder commonly refer to emergency services. Due to the absence of specific guidelines for the emergency setting and to a possible lack of knowledge, these patients are at risk of being unrecognized and mismanaged. This study aims at proposing a clinical practice to approach and manage these patients and their families in the emergency setting.Methods: This manuscript derived from the work of a research group of italian pediatric emergency physicians and anesthesiologists, with an expertise in pain management, members of the PIPER group. The research group reviewed the literature about psychosomatic pain and somatic symptom disorder and developed a clinical practice specific for the pediatric emergency setting. Results: The manuscript provides information about the main clinical features shared by patients with psychosomatic pain and about current diagnostic criteria and appropriate management in the emergency setting. Furthermore, it highlights the possible pitfalls in which the emergency physician may run into dealing with these patients.Conclusion: This clinical practice should be seen as a starting point toward a better understanding of patients with psychosomatic pain and a standardization of care in the pediatric emergency setting.

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Section: Discussionmentioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

How to Recognize and Manage Psychosomatic Pain in the Pediatric Emergency Department

Cozzi

Lucarelli

Borrometi³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The AACAP practice parameters date from 2001(http://www.jaacap.com/article/S0890-8567(09)60355-5/pdf). Other recommendations/reports focus on ED management of pediatric mental health crises, including two clinical reports 37,38 supporting previous joint policy statements of the American Academy of Pediatrics (AAP) and ACEP on pediatric mental health emergencies, and one 2015 review including recommendations for youths with SU/SH. 10…”

Section: Introductionmentioning

confidence: 87%

The Emergency Department

Asarnow

Babeva

Horstmann

2017

Child and Adolescent Psychiatric Clinics of North America

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Emergency departments (EDs) can offer life-saving suicide prevention care. This article focuses on the ED and emergency services as service delivery sites for suicide prevention. Characteristics of EDs, models of emergency care, ED screening and brief intervention models, and practice guidelines and parameters are reviewed. A care process model for youths at risk for suicide and self-harm is presented, with guidance for clinicians based on the scientific evidence. Strengthening emergency infrastructure and integrating effective suicide prevention strategies derived from scientific research are critical for advancing suicide prevention objectives.

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“…In recent years, emergency physicians have witnessed a constant increase in the number of children and adolescents presenting to the emergency department (ED) for mental health problems . Great attention is focused on patients with an immediate risk of death, such as children and adolescents with self‐injury, substance abuse and suicidal ideation or planning .…”

mentioning

confidence: 99%

“…Great attention is focused on patients with an immediate risk of death, such as children and adolescents with self‐injury, substance abuse and suicidal ideation or planning . However, there is a consistent population of children and adolescents that frequently attends the ED, presenting with physical symptoms without a clear connection with an organic aetiology, which may be labelled functional, somatic or medically unexplained symptoms and which may be difficult for the emergency physician to address …”

mentioning

confidence: 99%

Facing somatic symptom disorder in the emergency department

Cozzi

Barbi

2018

J Paediatrics Child Health

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Somatic symptom disorder is a condition in which a patient's subjective report of physical symptoms is associated with distress; disruption of day-to-day functioning; or disproportionate thoughts, feelings and behaviours regarding the symptoms, whether or not they are associated with an identified medical condition. While somatic symptom disorder affects a considerable proportion of children and adolescents presenting to the emergency department (ED), it has not been well investigated in the ED literature, nor is there much formal training in, or guidelines for, how to care for affected patients in the ED. The aim of this paper is to highlight the historical clues commonly reported by these patients in order to try to help the emergency physicians recognise patients affected by a somatic symptom disorder. Adolescent age, the presence of daily subjective symptoms presenting daily for weeks or months, a long medical history record, an extensive diagnostic workup and, most of all, disproportionate functional impairment related to the symptoms are all features strongly suggestive of this disorder. Emergency physicians should become used to taking advantage of these clues to formulate a positive diagnosis of somatic symptom disorder according to the most recent diagnostic criteria. Emergency physicians have the unique opportunity to contribute to the correct diagnosis and treatment of these patients and to have a positive impact on their prognosis.

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Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms

Cited by 22 publications

References 146 publications

How to Recognize and Manage Psychosomatic Pain in the Pediatric Emergency Department

How to Recognize and Manage Psychosomatic Pain in the Pediatric Emergency Department

The Emergency Department

Facing somatic symptom disorder in the emergency department

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