Somatization in childhood and adolescence: a guide to facilitate its understanding

Abstract

Somatic symptoms affect approximately 25% of children and adolescents, with a significant impact in 10%, and somatization disorders affect 1%–3% of the population. In addition to somatic symptom disorder, illness anxiety disorder (or hypochondria), conversion disorder and factitious disorder may be common reasons for seeking care. Somatization is associated with anxiety and depressive symptoms throughout the lifespan. There are widespread myths regarding somatization, and it is essential that all professionals who treat children are familiar with them. The basis of the treatment of somatization is the development of an individualized rehabilitation program with the main goal of gradually returning to normal function. A paediatrician, psychiatrist or psychologist can direct the treatment, but the approach must always be interdisciplinary, including nursing staff, physical and occupational therapists, teachers or school counsellors. There is limited evidence on the treatment of somatic symptoms, but cognitive behavioural therapy and antidepressants have been found to be effective in cases of greater severity or with psychiatric comorbidity. Analgesics should be used rationally, favouring non-pharmacological pain management measures.