title: Characteristics of medically hospitalized pediatric patients with somatoform diagnoses.
abstract: OBJECTIVE
  To describe demographic, diagnostic, and psychosocial characteristics of medically admitted patients diagnosed with somatoform disorders.
  
  
  METHODS
  Retrospective chart reviews were performed for pediatric patients (ages 3-18 years) seen by the Psychiatry Consultation Service in 2010 and 2011 on inpatient medical/surgical units and diagnosed with somatoform disorders. Data included demographic information; patient medical history, physical symptom characteristics, and service utilization; psychiatric diagnoses, history, and comorbidities, patient temperament, and coping style; family characteristics; and academic and social characteristics.
  
  
  RESULTS
  Mean age for the 161 identified patients was 14.4 years. The majority of patients were female (75%) and white (73%). Chief physical symptoms were pain (58%) and neurologic symptoms (40%); 73% of patients had medical diagnoses, and 66% had a history of prior psychiatric treatment. The most common somatoform diagnoses, using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, were pain (50%) and conversion disorders (28%). Psychiatric comorbidities were predominantly mood and anxiety disorders (42% and 29%, respectively). Mean hospitalization length was 4.9 days, with 14% of patients readmitted with psychiatric reinvolvement during the study period. Patients had sensitive temperaments (80%) and internalizing coping styles (76%) and were described as "good children" (72%). School absences (55%), academic pressures (51%), and learning difficulties (36%) were reported.
  
  
  CONCLUSIONS
  Clarifying the prevalence and nature of such characteristics can help pediatric providers improve patient care and minimize unnecessary medical interventions with early detection of risk for somatoform processes, provision of psychoeducation for patients and families, and early referral to mental health clinicians.
authors.affiliation: Boston Children's Hospital and Harvard Medical School, Boston, MA Simona.Bujoreanu@childrens.harvard.edu.
authors.forename: Simona
authors.initials: S
authors.lastname: Bujoreanu
authors.affiliation: Boston Children's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Edin
authors.initials: E
authors.lastname: Randall
authors.affiliation: Boston Children's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Katharine
authors.initials: K
authors.lastname: Thomson
authors.affiliation: Boston Children's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ibeziako
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology; D013001:Somatoform Disorders / Q000453:epidemiology* / Q000523:psychology
keywords: inpatient; pediatric; somatoform disorders