Deciphering emotional aches and physical pains in children

Pain syndromes in children are common and can often be associated with stress, which can have biological as well as psychiatric concomitants. After a comprehensive evaluation is performed, an overall intervention plan should be presented to the child and family. Pediatricians need to be sensitive to the negative stigma attached to treatment directed at mood and behavior, and nonpharmacologic interventions should be considered before any psychopharmacologic intervention is instituted. Finally, pediatricians should always regard pain as "real," and the child psychiatrist can play an important role in integrating care of patients with chronic physical complaints.