Identification and Management of Somatic Symptoms and Emotional Disturbance

Somatic Symptoms or Medically Unexplained Symptoms are commonly found in children and adolescents. These symptoms generally reflect the underlying psychological distress and cause significant distress to the child. Presenting symptoms include abdominal pain, headaches, and musculoskeletal pain. The nature of illness prompts multiple visits to clinical setups, burdening the existing health resources. Risk factors include individual, family, and environmental factors. Most stressful factors are seen to arise from day-to-day problems in children like academic problems, bullying, familial disharmony, temperamental traits, abuse, financial constraints, and parenting issues. Psychiatric and physical comorbidities are prevalent. During the assessment, it is pertinent to rule in positive signs and keep in mind the common psychiatric/physical differentials. Management includes a multidisciplinary approach involving the child and family. An overall visualization of the biopsychosocial framework of the child is done to cater to specific needs. Psychoeducation remains a key strategy, while incorporating behavioral management. This includes promoting strengths and positive behavior in child, gradual reduction in secondary gains, promotion of general well-being, focus on a well-rounded schedule incorporating different activities, and relaxation training. Psychosocial factors are worked upon at length while enhancing coping skills. Familial factors are taken into consideration and home environment may be improved. Comorbidities if present can be managed with medications. The goal is functional recovery and rehabilitation, which can be time taking and requires patience from the treating team.