School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC.
BC Children's Hospital Research Institute, Vancouver, BC.
CJEM. 2020 May;22(3):331-337. doi: 10.1017/cem.2019.477.
Somatization is a common phenomenon that can severely complicate youths' functioning and health. The burden of somatization on pediatric acute care settings is currently unclear; better understanding it may address challenges clinicians experience in effectively caring for somatizing patients. In this study, we estimate the prevalence of somatization in a pediatric emergency department (ED).
We conducted a retrospective cross-sectional study of visits for non-critical, non-mental health-related concerns (n = 150) to a quaternary-level pediatric ED between July 2016 and August 2017. Demographic and clinical visit details were collected through chart review and used by two reviewing clinicians to classify whether each visit had a "probable," "unclear" (possible), or "unlikely" somatizing component.
Approximately 3.33% (n = 5) of youth displayed probable somatization, and an additional 13.33% (n = 20) possibly experienced a somatizing component but require additional psychosocial and visit documentation to be certain. Longer symptom duration and multiple negative diagnostic tests were associated with a higher likelihood of either probable or possible somatization.
A considerable proportion of non-mental health-related visits may involve a somatizing component, indicating the burden of mental health concerns on the ED may be underestimated. A higher index of suspicion for the possibility of somatization may support clinicians in managing somatizing patients.
躯体化是一种常见的现象，可严重影响青少年的功能和健康。目前尚不清楚躯体化对儿科急症环境的负担；更好地了解它可以解决临床医生在有效照顾躯体化患者方面遇到的挑战。在这项研究中，我们估计了儿科急诊部（ED）躯体化的患病率。
我们对 2016 年 7 月至 2017 年 8 月期间在四级儿科 ED 就诊的非危急、非心理健康相关问题（n=150）进行了回顾性横断面研究。通过病历回顾收集人口统计学和临床就诊详细信息，并由两名审核临床医生使用这些信息来分类每个就诊是否具有“可能”、“不确定”（可能）或“不太可能”的躯体化成分。
大约 3.33%（n=5）的青少年表现出可能的躯体化，另有 13.33%（n=20）可能经历了躯体化成分，但需要更多的心理社会和就诊记录来确定。较长的症状持续时间和多项阴性诊断测试与更有可能出现可能或确定的躯体化有关。
相当一部分非心理健康相关就诊可能涉及躯体化成分，这表明 ED 中心理健康问题的负担可能被低估。对躯体化可能性的更高怀疑指数可能支持临床医生管理躯体化患者。
