Somatization and somatoform disorders

Author(s): Elena Garralda
doi: 10.1383/psyt.2005.4.8.97


Print ISSN: 1476-1793
Volume: 4 | Issue: 8 Child psychiatry 3
Cover date: August 2005
Page(s): 97-100


child psychiatry, clinical syndromes, somatization, somatoform
disorders, unexplained medical symptoms, emotional disorder co-
morbidity, personality features

Abstract text

Medically unexplained somatic symptoms are common in children and
adolescents. They can be an expression of somatization (i.e.
psychological difficulty/distress manifested through somatic
symptoms which are attributed to physical illness), and/or of a
somatoform disorder. The most common somatoform disorders in
children are persistent somatoform pain disorder and
dissociative/conversion disorder. Chronic fatigue syndrome — known
as `neurasthenia' in ICD-10 — shares the key features of somatoform
disorders. This chapter outlines the main clinical characteristics
of recurrent medical unexplained somatic symptoms and somatoform
disorders in children. Onset is often insidious but some problems
are brought on by a medical condition or injury. Psychiatric co-
morbidity is common, especially emotional disorder. Risk factors in
the child include certain personality features (ie sensitivity,
anxiety-proneness and conscientiousness). Risk factors in the family
involve a history of both physical and psychological problems and
symptom reinforcement. Treatment involves taking the symptoms
seriously and clarification of medical investigations and
exclusions, psycho-education, reducing attention to the symptoms
whilst relieving stresses and increasing supports for the child in
school and at home as appropriate. It may involve family
behavioural/cognitive work. Many children improve.

Author Biography

Elena Garralda is Professor of Child and Adolescent Psychiatry at
Imperial College London, UK, and Honorary Consultant Child and
Adolescent Psychiatrist with Central and North West London Mental
Health NHS Trust, London. Her research interests include
psychosomatic problems in children and the interface between child
and adolescent mental health services with general practice and

Author(s): Elena Garralda