Somatic symptom and related disorders in children

[GarryDrold]

In somatic symptom and related disorders (formerly called somatoform disorders), children may have an exceptionally intense response to physical symptoms they have, think excessively about the symptoms, worry excessively about the symptoms, overuse medical care, and allow health concerns to become the focus of their life.

There are several types of somatic symptom and related disorders.
Symptoms may resemble those of a neurologic disorder (such as paralysis or loss of vision) or be vague (such as headache and nausea), or children may be obsessed with an imagined defect or be convinced that they have a serious disease.
After doing tests to exclude physical disorders that could cause the symptoms, doctors base the diagnosis on symptoms.
Individual and family psychotherapy, often using cognitive-behavioral techniques, can help.

Symptoms and treatment of somatic symptom and related disorders are very similar to those of anxiety disorders.
Somatic symptom and related disorders include the following:

Conversion disorder: Symptoms resemble those of a nervous system disorder. Children may have a paralyzed arm or leg, become deaf or blind, or have shaking that may resemble a seizure. The symptoms are commonly triggered by mental factors such as conflicts or other stresses.
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.
Factitious disorder imposed on self: The child may pretend to have physical symptoms or do something to themselves to produce physical symptoms.
Illness anxiety disorder: Children are extremely worried that they are ill or might become ill. They may or may not have physical symptoms or an actual medical disorder. If they do have symptoms or a disorder, their worries are out of proportion to the seriousness of the situation. They may also feel anxious and depressed.
Somatic symptom disorder: Children may develop many symptoms or only one severe symptom, typically pain. Symptoms may be specific (such as pain in the abdomen) or vague (such as fatigue). Any part of the body may be the focus of concern. Children worry excessively about these symptoms and their possible consequences.

Somatic symptom and related disorders are equally common among young boys and young girls but are more common among adolescent girls than adolescent boys.
(See also Overview of Somatic Symptom and Related Disorders in adults.)

[Vania]

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.