Frequent visitors: somatization in school-age children and implications for school nurses.

There is a gap in the nursing literature regarding children who frequently visit school nurses' offices with recurrent unexplained physical symptoms. A review of the scientific health literature was undertaken to examine the clinical presentation, associated variables, and implications for school nurses regarding children who are frequent school health office visitors with somatic symptoms. This subset of students with medically unexplained symptoms accounts for disproportionate use of primary care and school health resources. Common somatic complaints in school-age children, such as headache and stomachache, are associated with the psychosocial variables of anxiety and depression, childhood adversity, and school stress. Effective and practical treatment approaches to this complicated child health issue require accurate identification, appropriate referral, screening for associated conditions, and individualized treatment plans. Research to identify effective interventions for frequent health office visitors is needed.