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儿童躯体形式障碍的临床特征。

Clinical profile of somatoform disorders in children.

机构信息

Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.

出版信息

Indian J Pediatr. 2011 Mar;78(3):283-6. doi: 10.1007/s12098-010-0282-z. Epub 2010 Nov 4.

Abstract

OBJECTIVE

To study the clinical profile, socio-demographic features, psychosocial stressors and outcome of somatoform disorders in children

METHODS

Children up to the age of 18 year presenting with unexplained physical symptoms over a period of 6 months were evaluated. A detailed history and physical examination was carried out. Appropriate investigations were undertaken to exclude organic causes. Diagnosis was made according to DSM-IV-TR criteria.

RESULTS

Forty-five children were diagnosed with somatoform disorders during the study period. The prevalence was 0.5% and 0.9% among outdoor and indoor patients, respectively. Conversion disorder (48.9%) was the commonest followed by other somatoform disorders (26.7%). Pseudoseizures and fainting attacks in conversion disorder and pain abdomen and general body pain in somatoform disorder were the commonest symptoms. Male to female ratio was 2.2:1. Urban children (25) were represented more than rural children (20). Stress factors were identified in 71.1% patients, which included fear of school or examinations. Thirty-three patients (73.3%) remained asymptomatic after counseling whereas, 8 patients (17.6%) had relapse requiring further counseling. Four patients (8.8%) showed no improvement and needed psychiatric evaluation.

CONCLUSIONS

Early referral to mental health professional is required to avoid unnecessary investigations and delay in diagnosis of somatoform disorders in children.

摘要

目的

研究儿童躯体形式障碍的临床特征、社会人口学特征、心理社会应激源和结局。

方法

对 6 个月内出现不明原因躯体症状的 18 岁以下儿童进行评估。进行详细的病史和体格检查。进行适当的检查以排除器质性原因。根据 DSM-IV-TR 标准进行诊断。

结果

研究期间共诊断出 45 例儿童躯体形式障碍。患病率分别为户外活动者的 0.5%和室内活动者的 0.9%。转换障碍(48.9%)最常见,其次是其他躯体形式障碍(26.7%)。转换障碍中最常见的症状是假性发作和晕厥发作,躯体形式障碍中最常见的症状是腹痛和全身疼痛。男女比例为 2.2:1。城市儿童(25 例)多于农村儿童(20 例)。71.1%的患者确定了应激因素,包括对学校或考试的恐惧。33 例(73.3%)患者在咨询后无症状,8 例(17.6%)患者复发需要进一步咨询。4 例(8.8%)患者无改善,需要精神科评估。

结论

需要及早向心理健康专业人员转介,以避免对儿童躯体形式障碍进行不必要的检查和延误诊断。

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