Unexplained Physical Complaints

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Definitions and general clinical issues

Physical complaints or somatic symptoms are common in children and adolescents, and the majority will have a physiologic explanation rather than one deriving from a diagnosable medical illness. Nevertheless, they often lead to pediatric visits. General population surveys show that young people report a mean of 2 somatic symptoms being present “a lot” in the 2 weeks before assessment; the most common being headaches, low energy, sore muscles, nausea and upset stomach, back pains, and stomach

Previous reviews

Several reports have reviewed the literature on unexplained physical complaints, and somatization and somatoform disorders as they manifest in children and young people. This article reviews first the main conclusions from these reviews and then considers new findings that have helped illuminate their nature and management.

The clinical picture, frequency and epidemiology, etiologic factors, and treatment of unexplained physical complaints have been reviewed comprehensively.2, 3, 4, 5 An early

Update on more recent findings

In recent years several studies have taken these issues forward, and are reviewed here briefly. These studies address the development of instruments to assist the investigation of unexplained physical symptoms in children, the contribution of symptoms to pediatric practice, and further work on associations with psychopathology, biologic and psychological vulnerabilities, sensibility to stress in the child, and familial influences, as well as on treatment and outcome. Because much of this work

Summary

Unexplained physical complaints are frequent in the general population. These complaints are commonly associated with somatization (the tendency to express psychological distress through somatic symptoms and to request medical help) the phenomenon at the root of the somatoform disorders, of which pain and conversion in addition to CFS are seen in children. There is evidence that psychiatric comorbidity is common, particularly anxiety and to a lesser extent depressive disorders and that children

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  • Cited by (30)

    • Daily stressor, daily resilience, and daily somatization: The role of trait aggression

      2020, Personality and Individual Differences
      Citation Excerpt :

      Somatic symptoms or somatization are medically unexplained symptoms including unpleasant bodily sensations (e.g., nausea) or physical dysfunctions (e.g., pains in heart/chest) in certain body parts or organs (Garralda, 2010).

    • When somatization is not the only thing you suffer from: Examining comorbid syndromes using latent profile analysis, parenting practices and adolescent functioning

      2016, Psychiatry Research
      Citation Excerpt :

      About 13–25% of all children report recurrent or continuous physical complaints, such as dizziness, headaches, abdominal pain, or fatigue (Perquin et al., 2000; Roth-Isigkeit et al., 2004). The majority of these complaints can be classified as physical functional complaints (PFC) or complaints with no straightforward medical cause (Campo, 2012; Garralda, 2010). The tendency to experience and report multiple PFCs is named somatization (De Gucht and Fischler, 2002), and is common in pediatric primary care (Campo, 2012).

    • A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 2: How is healthcare perceived?

      2015, Journal of Adolescence
      Citation Excerpt :

      In fact, a recent review suggested that parental decisions to seek healthcare for their children may reflect parental health attitudes, health beliefs and consulting behavior, rather than the children's needs (Shraim, Mallen, & Dunn, 2013). Moreover, engaging and working with the family to share common expectations is necessary before effective treatment can be undertaken (Garralda, 2010). As explained elsewhere (Moulin et al., 2015), the main limitation of our study was the participation rate.

    • Concepts of psychosomatic conditions

      2022, Behavioral Pediatrics II: Neuropsychiatry, Sexuality and Eating Disorders. Fifth Edition
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