Somatic symptom disorder and related disorders are characterized by persistent physical symptoms that are associated with excessive or maladaptive thoughts, feelings, and behaviors in response to these symptoms and associated health concerns. These disorders are distressing and often impair functioning.
(See also Overview of Somatization.)
Somatic symptom and related disorders include the following:
Conversion disorder: Typically, symptoms involve apparent deficits in voluntary motor or sensory function but sometimes include shaking movements and impaired consciousness (suggesting seizures) and abnormal limb posturing (suggesting another neurologic or general physical disorder). Children may present with impaired coordination or balance, weakness, paralysis of an arm or a leg, loss of sensation in a body part, seizures, unresponsiveness, blindness, double vision, deafness, aphonia, difficulty swallowing, sensation of a lump in the throat, or urinary retention.
Factitious disorder imposed on another: Caregivers (typically a parent) intentionally falsify or produce physical symptoms in a child. For example, they may add blood or other substances to urine specimens to simulate a urine infection.
Illness anxiety disorder: Children are extremely afraid that they have or will acquire a serious disorder. They are so preoccupied with the idea that they are or might become ill that their anxiety impairs daily functioning or causes significant distress. Children may or may not have physical symptoms, but if they do, their concern is more about the possible implications of the symptoms than the symptoms themselves.
Somatic symptom disorder: Children may develop multiple somatic symptoms or only one severe symptom, typically pain. Symptoms may be specific (eg, pain in the abdomen) or vague (eg, fatigue). Any part of the body may be the focus of concern. The symptoms themselves or excessive worry about them is distressing or disrupts daily life.
Somatic symptom and related disorders are equally common among young boys and young girls but are more common among adolescent girls than adolescent boys.
Symptoms and treatment of somatic symptom and related disorders are very similar to those of anxiety disorders. The symptoms are not consciously fabricated, and children are actually experiencing the symptoms they describe.
