Clinical profile of pediatric somatoform disorders.
OBJECTIVE
To study the prevalence, pattern, clinical and socio-demographic characteristics of somatoform disorders in children.


METHODS
From Aug 2004 to July 2005, children up to 18 years with unexplained physical symptoms were evaluated prospectively using DSM-IV criteria. Detailed evaluation followed for those meeting criteria.


RESULTS
The prevalence of Somatoform disorders was 0.59% and 0.78% among out-door and in-door patients respectively. Among 124 children (40 boys and 84 girls) meeting criteria, conversion disorder was the commonest (57.3%), followed by undifferentiated somatoform disorder (25.2%). Girls were significantly more represented among conversion disorder patients compared to other groups of somatoform disorders (78.9 vs. 52.8 %, P=0.002). In conversion disorder, 2/3rd patients presented within 3 months, whereas in other somatoform disorders, 2/3rd patients presented within 3 months after symptoms. Fainting attacks (52.1%) and ataxia (43.7%) in conversion disorder and pain abdomen (52.8%) and headache (52.8%) in other somatoform disorders, were the commonest symptoms. Stressors were identified in 73.4% and acute precipitating stressors were present in 14.4% children. Boys had significantly higher rates of poor inter-personal relations and communication problems within the family (72.5% vs. 41.7%, P=0.001), while girls had significantly higher rates of conflicts with the parents and other family members (21.4% vs. 5%, P=0.02).


CONCLUSIONS
Somatoform disorders, particularly conversion disorder is commoner in girls. Important stressors are poor inter-personal relations and communication problems within the family in boys, and conflicts with family members among girls.
Bisht
Jaipal
J
Department of Pediatrics, IGMC, Shimla, Himachal Pradesh, India.
Sankhyan
Naveen
N
Kaushal
Ram Krishan
RK
Sharma
Ravi C
RC
Grover
Neelam
N
D015746:Abdominal Pain / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D003142:Communication; D003291:Conversion Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013575:Syncope / Q000453:epidemiology*