Pediatric Somatic Symptom Disorders

Abstract

Somatic symptom disorder (SSD) is a common disorder encountered in pediatric medicine. It involves the presentation of physical symptoms that are either disproportionate or inconsistent with history, physical examination, laboratory, and other investigative findings. SSDs result in significant impairment with considerable increase in healthcare utilization, school absenteeism, and the potential for unnecessary diagnostic evaluation and treatment intervention. Patients and families often feel dismissed and may worry that a serious condition has been missed. Primary care providers are frequently frustrated due to a lack of a successful approach to patients and families impacted by SSD. The result is often a cycle of disability, frustration and missed opportunities for collaboration towards enhanced patient functionality. This review summarizes the current evidence-based understanding, as well as insights from clinician experience, on the evaluation and management of pediatric SSD.

Chronic school absenteeism as a diagnostic clue for paediatricians

“…12 In the same way, chronic school absenteeism is a typical feature of a somatic symptom disorder. 13 Somatic symptom disorder is a condition in which a patient's subjective report of physical symptoms is associated with distress and disruption of everyday functioning, with disproportionate thoughts, feelings and behaviours regarding those symptoms. 14 Usually, symptoms are not relieved by standard medications and last for months or even years.…”

Psychiatric comorbidity in children with psychogenic and functional breathing disorders

“…Half of those who fulfilled this criteria had additional symptoms such as fatigue, headache, and lack of appetite. It is well‐demonstrated in the literature that children with somatic symptom disorder have more unexplained physical symptoms, and a lower level of functioning . Interestingly, most children did not show the second diagnostic criteria of somatic symptom disorder which is “excessive thoughts, feelings, or behaviors related to the somatic symptoms.” Parents seemed to be more worried about the symptoms than their children.…”

“…Half of those who fulfilled this criteria had additional symptoms such as fatigue, headache, and lack of appetite. It is well-demonstrated in the literature that children with somatic symptom disorder have more unexplained physical symptoms, 21 and a lower level of functioning. 22 Interestingly, most…”

Efficacy of Cyberbullying Prevention on Somatic Symptoms—Randomized Controlled Trial Applying a Reasoned Action Approach

“…At the same time, these symptoms are sometimes overlooked as consequences of peer victimization and are instead associated with biological causes or diseases. They might thus lead to unnecessary medical examinations or procedures (Cozzi et al., ; Malas et al., ).…”

“…These unspecific symptoms are mostly headaches, stomachaches, dizziness, heat spells, or heart palpitations. They can be caused, in part, by stressful psychological experiences such as cyberbullying, even though they emerge as an interaction of biological, psychological, and interpersonal variables (Malas, Ortiz-Aguayo, Giles, & Ibeziako, 2017;Sumter & Baumgartner, 2017).…”