NCJ Number
205431
Journal
Child Maltreatment Volume: 9 Issue: 2 Dated: May 2004 Pages: 169-176
Date Published
May 2004
Length
8 pages
Annotation
This article reviews current knowledge about somatoform disorders in children and adolescents, which occur more often in children and adolescents who have been severely maltreated than in other juveniles; and it identifies the symptoms of somatoform disorders, strategies for distinguishing somatoform disorders from other disorders, and treatment strategies.
Abstract
A somatoform disorder is likely to be present when a child has a physical complaint that, upon a thorough medical examination, has no organic basis. It can also be present when a child with an identified organic disorder has symptoms that are much more severe than warranted by the disorder. The symptoms must cause significant distress or impairment and may not be primarily due to substance use or another mental disorder. Although somatoform disorders are rare in children, severe forms of child sexual abuse have been associated with higher rates of somatization problems. Somatoform disorders may be particularly difficult to diagnose in children who have been severely physically abused, since it may be unclear as to whether old or recent injuries are the cause of the child's physical complaints. This article profiles several disorders that are included in the category of somatoform disorders and those that are most common among children. These are somatization disorder, undifferentiated somatoform disorder, body dysmorphic disorder, conversion disorder, pain disorder, hypochondriasis, and vocal-chord dysfunction. Influences on the development of somatization are discussed as organic vulnerability, stress, learning, family issues, and physician issues. A section of this article also discusses the importance of distinguishing between somatoform disorders and undiagnosed medical illness, depression and anxiety disorders, obsessive-compulsive disorder, and dissociative disorders. Other sections of the article discuss obstacles to recognizing somatization in children, behaviors associated with somatization in children, and treatment interventions. Treatment for somatization problems typically involves promoting changes in the reinforcement that a child receives for reporting symptoms and helping the child to develop strategies for coping with his/her physical symptoms and other distress. Suggestions are offered for interventions with families and interventions at school, with medical providers, and with others involved in the child's life. A case study is provided. 2 notes and 25 references