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Psychosomatic disorders in pediatrics.

S R Brill1, D R Patel, E MacDonald

  • 1Overlook Hospital Children's Medical Centre, Summit, New Jersey and Michigan State University, Kalamazoo Centre for Medical Studies, Kalamazoo, Michigan, USA.

Indian Journal of Pediatrics
|August 25, 2001
PubMed
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Psychosomatic symptoms in children and adolescents, often linked to stress, present without organic causes. Differentiating these common complaints requires careful medical and psychosocial evaluation to ensure proper care.

Area of Science:

  • Pediatric Psychology
  • Psychosomatic Medicine
  • Child and Adolescent Health

Background:

  • Psychosomatic symptoms are clinical manifestations without identifiable organic pathology.
  • Commonly observed in pediatric populations, these include abdominal pain, headaches, and fatigue.
  • Prevalence rates in children and adolescents range from 10% to 25%.

Observation:

  • Symptoms are theorized to be stress responses, with potential stressors including academic, familial, and social factors.
  • Key characteristics favoring a psychosomatic basis include vague, inconsistent symptoms, chronicity with apparent good health, and delayed medical care seeking.
  • Diagnostic evaluation relies heavily on comprehensive medical and psychosocial history and physical examination.

Findings:

  • Psychosomatic symptoms in youth are distinct from adult somatoform or neurotic disorders.

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  • Stressors such as schoolwork, family issues, and peer pressure are implicated.
  • A pattern of multiple, vague, and chronic symptoms often suggests a psychosomatic origin.

    • Implications:

    • Accurate differentiation from organic conditions is crucial for appropriate management.
    • Ruling out organic etiology is a primary step in diagnosis.
    • Mental health consultation is recommended for further evaluation and treatment of psychosomatic complaints in children and adolescents.