One hundred cases of recurrent abdominal pain in children: diagnostic procedures and criteria for a psychosomatic diagnosis.
OBJECTIVE
To highlight the diagnostic difficulties involved in elucidating the aetiology of recurrent abdominal pain and to evaluate the use of special premises and criteria for the diagnosis of psychosomatic pain.


METHODS
The study included 100 consecutive cases of recurrent abdominal pain in 6 to 15 y-old children who were evaluated at a special paediatric clinic for recurrent abdominal pain and who were followed for at least one year. The investigation included a semi-structured questionnaire, laboratory investigations based on clinical data and diagnoses based on defined criteria. Three premises and seven criteria, based on the assumption that chronic negative stress can cause recurrent pain, were used for the diagnosis of psychosomatic pain.


RESULTS
When the presented premises and criteria were employed for the diagnosis of psychosomatic pain, nearly half of the cases (48%) of recurrent abdominal pain could be explained. An organic or possibly organic diagnosis was found in 25% of the cases. Fourteen children had a possible psychosomatic diagnosis and in 9 cases no known diagnosis could be reached.


CONCLUSIONS
The presented premises and criteria for the diagnosis of psychosomatic pain can be helpful when diagnosing recurrent abdominal pain, but further validation is needed. According to these criteria, a psychosomatic diagnosis was common in this series, accounting for nearly half of the cases. A medical diagnosis was evident in a quarter of the cases.
Alfvén
G
G
Department of Paediatrics, Huddinge Hospital, Hallunda Child Health Clinic, Norsborg, Sweden. gosta.alfven@slmk.org
D015746:Abdominal Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000453:epidemiology / Q000652:urine; D006801:Humans; D007787:Lactose Intolerance / Q000150:complications* / Q000453:epidemiology; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000150:complications* / Q000175:diagnosis*; D012008:Recurrence; D012720:Severity of Illness Index