• DOI:10.1542/pir.32-2-56
• Corpus ID: 29888297

Somatization disorders: diagnosis, treatment, and prognosis.

@article{Silber2011SomatizationDD,
  title={Somatization disorders: diagnosis, treatment, and prognosis.},
  author={Tom{\'a}s jos{\'e} Silber},
  journal={Pediatrics in review},
  year={2011},
  volume={32 2},
  pages={
          56-63; quiz 63-4
        }
}

• T. Silber
• Published 1 February 2011
• Medicine, Psychology
• Pediatrics in review

1. Tomas Jose Silber, MD*

1. *Professor, Department of Pediatrics, The George Washington University School of Medicine and Health Sciences; Director, Adolescent Medicine Fellowship Program, Children's National Medical Center, Washington, DC.

After completing this article, readers should be able to:

1. Identify the various manifestations of somatization disorders in children and adolescents.

2. Understand the association of psychosomatic disorders with personality traits and stressors such as physical and sexual abuse, bullying, parental anxiety, and pressure for a child to perform.

3. Recognize secondary gains of somatization disorders.

4. Explain why it is necessary to focus on school attendance and the management of school avoidance.

5. Develop a partnership with patients and their parents to address the symptoms of a somatization disorder.

6. Plan the treatment and management of somatization disorders

Children and adolescents suspected of having somatization disorders present a challenge to pediatricians. Clinicians are often concerned about “missing something,” while also worrying about alienating both the patient and the family when explaining the condition. Many clinicians are baffled by the onslaught of symptoms, feel frustrated by the never-ending recurrent complaints, or become annoyed by the time consumed in caring for patients who might be perceived as “not really being sick.”

The research on somatization disorders is neither easily available nor conclusive. Moreover, paradoxically, although somatoform disorders in children have been defined as psychiatric disorders, psychiatrists seldom see these patients. By default, most children and adolescents who have symptoms are seen by primary care physicians. (1)(2)(3)(4)

This review focuses on understanding, assessing, and developing strategies for managing somatization disorders.

Somatization is “the tendency to experience and communicate somatic distress and symptoms unaccounted by pathological findings.” (5) However, it must be stressed that somatization can coincide with another illness. Somatization is deemed to exist in conjunction with a physical illness whenever the physical …