Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
Indian J Pediatr. 2011 Mar;78(3):283-6. doi: 10.1007/s12098-010-0282-z. Epub 2010 Nov 4.
To study the clinical profile, socio-demographic features, psychosocial stressors and outcome of somatoform disorders in children
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.
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.
Early referral to mental health professional is required to avoid unnecessary investigations and delay in diagnosis of somatoform disorders in children.
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。
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。
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。
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。