Somatization in pediatric primary care: association with psychopathology, functional impairment, and use of services.
OBJECTIVE
To determine whether classification as pediatric "somatizers" identifies a group of children and adolescents at high risk for psychopathology, functional impairment, and frequent use of health services in a large, multisite study of pediatric primary care.


METHODS
Parental reports of frequent aches and pains and visits to the doctor for medically unexplained symptoms in children aged 4 to 15 years were used to construct a classification of somatization in pediatric primary care. Affected and unaffected children and adolescents were compared on measures of demographics, family functioning, psychopathology, functional status, and service use.


RESULTS
Classification as a somatizer was more common in adolescents, females, minority subjects, urban practices, nonintact families, and families with lower levels of parental education and was associated with heightened risk of clinician- and parent-identified psychopathology, family dysfunction, poor school performance and attendance, perceived health impairment, and more frequent use of health and mental health services.


CONCLUSIONS
Children classified as pediatric somatizers are at heightened risk for psychiatric disorder, family dysfunction, functional impairment, and frequent use of health services. Additional research is warranted, and clinicians should recognize the need for careful assessment and potential behavioral health referral in this population.
Campo
J V
JV
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, USA. campojv@msx.upmc.edu
Jansen-McWilliams
L
L
Comer
D M
DM
Kelleher
K J
KJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010146:Pain / Q000523:psychology; D010287:Parent-Child Relations; D010372:Pediatrics; D011320:Primary Health Care; D012017:Referral and Consultation; D012307:Risk Factors; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology*