title: Clinical features of functional somatic symptoms in children and referral patterns to child and adolescent mental health services.
abstract: OBJECTIVE
  Functional somatic symptoms (FSS) are common in paediatric patients who are referred to Child and Adolescent Mental Health Service (CAMHS), but little is known about current referral practices. The aim of this study was to systematically investigate clinical features of paediatric inpatients with FSS referred to CAMHS and to describe why paediatricians referred them.
  
  
  METHODS
  The study population comprised 60 children with FSS admitted to a large Danish paediatric department during 2012. We compared medical record data on the clinical characteristics and paediatric management of 16 children who had been referred and 44 children who had not.
  
  
  RESULTS
  Most paediatric records lacked information on psychosocial factors and symptoms. Referred children were significantly more multisymptomatic of FSS (p < 0.01) than the controls, had longer symptom duration, underwent more clinical investigations, had longer paediatric admissions of at least two weeks and received more treatment elements before referral. The most frequently stated referral reason was inadequate treatment response.
  
  
  CONCLUSIONS
  Paediatric inpatients with more severe FSS were more likely to be referred to CAMHS, but referral reasons were generally vague and psychosocial information was frequently missing. Clinical guidelines are needed to improve and systematise mental health referrals for children with FSS.
authors.affiliation: Department of Child and Adolescent Psychiatry Odense, Odense University Hospital, Odense, Region of Southern Denmark, Denmark.
authors.forename: Simone
authors.initials: S
authors.lastname: Tøt-Strate
authors.affiliation: Department of Child and Adolescent Psychiatry Odense, Odense University Hospital, Odense, Region of Southern Denmark, Denmark.
authors.forename: Gitte
authors.initials: G
authors.lastname: Dehlholm-Lambertsen
authors.affiliation: Department of Paediatrics, Odense University Hospital, Odense, Region of Southern Denmark, Denmark.
authors.forename: Karin
authors.initials: K
authors.lastname: Lassen
authors.affiliation: The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.|Regional Centre for Child and Adolescent Psychiatry, Risskov, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Charlotte Ulrikka
authors.initials: CU
authors.lastname: Rask
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D003718:Denmark; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D000071896:Medically Unexplained Symptoms; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010372:Pediatrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*
keywords: Child; Child and adolescent mental health services; Functional somatic symptoms; Somatisation