[Somatic manifestations among depressed children: the case of complains and conversion symptoms]

If all authors agree on the presence of fundamental changes in mood, as the basis of the diagnosis of depression, little importance is accorded to other symptoms that can mislead the diagnosis: in particular, age and cultural influence on depressive symptoms.

Our work aims to describe and assess the frequency of somatic complaints and symptoms of conversion in Tunisian children and adolescents followed for depressive disorders, and to compare, through a study of literature to populations from different cultures.

This work consisted in a retrospective review of children who consulted the Department of Child Psychiatry between 2008 and 2011 and in whom the diagnosis of depressive disorders was retained according to DSM IV criteria. Were searched all the conversion symptoms corresponding to the DSM IV diagnoses of conversion and dissociative disorders, as well as all the somatic complaints reported. Children with organic were excluded in order not to confuse the pain secondary to these disorders from those associated with depression. Also, children with mental retardation, moderate, severe or profound were not included because their difficulties of expression can alter the semiological assessment.

119 children and adolescents aged 6 to19 years were included in the study. The mean age of the population was 11.6 years. Somatic complains were present in 37% of cases. Headaches were mostly represented (27.7%), followed by abdominal pain (14.3%). The presence of somatic complaints was significantly correlated with the presence of a comorbid anxiety (p=0.035). Conversion symptoms were present in 22.7% of cases. They were significantly more frequent among girls (p=0.006) and in children whose father had a low level of education (p=0,013). Among the conversions, fainting were more common in girls (p=0.004), when the father's educational level was low (p=0.001), and when the geographical origin was rural (p=0.016).

Conversion symptoms and somatic complaints are frequent in depressed children.