Clinical profile of somatoform disorders in children.
OBJECTIVE
To study the clinical profile, socio-demographic features, psychosocial stressors and outcome of somatoform disorders in children


METHODS
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.


RESULTS
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.


CONCLUSIONS
Early referral to mental health professional is required to avoid unnecessary investigations and delay in diagnosis of somatoform disorders in children.
Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India. vineetaguptabhu@gmail.com
Vineeta
V
Gupta
Aparna
A
Singh
Shashi
S
Upadhyay
Baldev
B
Bhatia
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003291:Conversion Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D011446:Prospective Studies; D012423:Rural Health; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D013315:Stress, Psychological; D016896:Treatment Outcome; D014504:Urban Health