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American Academy of Pediatrics
Research Articles

Characteristics of Medically Hospitalized Pediatric Patients With Somatoform Diagnoses

Simona Bujoreanu, Edin Randall, Katharine Thomson and Patricia Ibeziako
Hospital Pediatrics September 2014, 4 (5) 283-290; DOI: https://doi.org/10.1542/hpeds.2014-0023
Simona Bujoreanu
Boston Children’s Hospital and Harvard Medical School, Boston, MA
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Edin Randall
Boston Children’s Hospital and Harvard Medical School, Boston, MA
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Katharine Thomson
Boston Children’s Hospital and Harvard Medical School, Boston, MA
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Patricia Ibeziako
Boston Children’s Hospital and Harvard Medical School, Boston, MA
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Abstract

Objectives: 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.

  • pediatric
  • somatoform disorders
  • inpatient
  • Abbreviations:
    DSM-IV-TR
    Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision
    PCS
    Psychiatry Consultation Service
    • Copyright © 2014 by the American Academy of Pediatrics
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    Hospital Pediatrics: 4 (5)
    Hospital Pediatrics
    Vol. 4, Issue 5
    1 Sep 2014
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    Characteristics of Medically Hospitalized Pediatric Patients With Somatoform Diagnoses
    Simona Bujoreanu, Edin Randall, Katharine Thomson, Patricia Ibeziako
    Hospital Pediatrics Sep 2014, 4 (5) 283-290; DOI: 10.1542/hpeds.2014-0023

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    Characteristics of Medically Hospitalized Pediatric Patients With Somatoform Diagnoses
    Simona Bujoreanu, Edin Randall, Katharine Thomson, Patricia Ibeziako
    Hospital Pediatrics Sep 2014, 4 (5) 283-290; DOI: 10.1542/hpeds.2014-0023
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    Subjects

    • Psychiatry/Psychology
      • Psychiatry/Psychology
    • Developmental/Behavioral Pediatrics
      • Developmental/Behavioral Pediatrics
      • Psychosocial Issues

    Keywords

    • pediatric
    • somatoform disorders
    • inpatient
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