Functional somatic symptoms in 5-7-year-old children: Assessment, prevalence and co-occurrence
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark. .Danish Medical Journal (Impact Factor: 1.07). 11/2012; 59(11):B4537.
Medically unexplained or functional somatic symptoms (FSS) in children constitute a major clinical problem. However, research data on FSS in young children are few, and epidemiological studies are hampered by lack of good standardised measures. The present thesis consists of two studies: In study one, we developed two measures to assess FSS in young children. The first measure is a parent interview, the Soma Assessment Interview (SAI), to assess the 1-year prevalence and associated impairment caused by FSS. The interview can be performed by lay interviewers and subsequently rated clinically by physicians. A preliminary validation showed a good agreement on FSS recognition between two clinical raters (kappa = 0.86), a good concurrent validity with independent measures of physical complaints and a good discrimination on the prevalence of FSS between a community sample and clinical samples. The second measure is a systematic medical record review of FSS in paediatric patients: the Medical Record Review for Functional Somatic Symptoms in Children (MRFC). Our findings suggest that the MRFC allows identification of subgroups of paediatric patients with multisymptomatic FSS and long-term and/or impairing FSS and it may prove useful for case finding in clinical and epidemiological research. In study two, we investigated the parent-reported FSS and their impairment in a population-based sample of Danish 5-7-year-old children. We used the SAI as the main measure. Data from 1,327 children from The Copenhagen Child Cohort 2000 were analysed. Impairing symptoms were defined as FSS causing substantial discomfort, impairment of everyday life, absence from daycare or school and/or health care seeking. We found that FSS are common in this age group with a 1-year prevalence of 23.2%. Different pain complaints, i.e. limb pain, abdominal pain and headache, were the most prevalent types of FSS. A subgroup of children with impairing FSS (4.4%) was identified. These children were more likely to present multisymptomatic FSS than children with non-impairing FSS. Health anxiety symptoms (HAS) and their associations with different physical health variables, including FSS, were investigated in the same population of 5-7-year-old children. In total, 2.4% presented prominent HAS, and the level of HAS was correlated with general poor health, chronic physical disease and physical complaints including FSS. In children with FSS, we found significant associations between the level of HAS and the impact of the childrens´ FSS in terms of number of doctor's visits and missed school and/or daycare due to FSS as well as the degree of parental worries about the childrens´ FSS. Furthermore, HAS were significantly associated with emotional symptoms. The findings suggest an early onset of somatisation and point to the need for clinical and preventive intervention in a substantial proportion of children. The findings also suggest a close link between HAS, FSS and emotional symptoms. Medically unexplained or functional somatic symptoms (FSS) in children constitute a major clinical problem. However, research data on FSS in young children are few, and epidemiological studies are hampered by lack of good standardised measures.
- [Show abstract] [Hide abstract]
ABSTRACT: Functional somatic symptoms (FSS) are common in children and adolescents, but explanatory models that synthesize research findings are lacking. This article reviews the studies published from January 2012 to March 2013 that investigate the neurophysiological mechanisms that may underlie FSS. Studies from diverse medical disciplines suggest that FSS are associated with functional differences in hypothalamic-pituitary-adrenal function, imbalances in vagal-sympathetic tone, upregulation of immune-inflammatory function, and primed cognitive-emotional responses that serve to amplify reactivity to threatening stimuli, thereby contributing to the subjective experience of somatic symptoms. FSS appear to reflect dysregulations of the stress system. When seemingly disparate research findings are interpreted together within an overarching 'stress-system' framework, a coherent explanatory model begins to emerge.Current opinion in psychiatry 07/2013; 13(5). DOI:10.1097/YCO.0b013e3283642ca0 · 3.94 Impact Factor
Article: New bronchiolitis guidelines[Show abstract] [Hide abstract]
ABSTRACT: Bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year old. The American Academy of Pediatrics (AAP) and the Italian Pediatric Society (SIP) have recently published new guidelines for the diagnosis, management and prevention of bronchiolitis. Indications in the two documents are similar, but bronchiolitis management is still debated. In particular pharmacological treatments are not supported by enough evidence, whereas support therapy with oxygen, hydration and nutrition seems the only useful option. The aim of the present work is to summarise these new guidelines, adding a brief comment to each recommendation, in order to produce a useful and practical everyday guide for the paediatricianMedico e Bambino 06/2015; 34(6):369-375.
- [Show abstract] [Hide abstract]
ABSTRACT: Pain is common in children presenting to emergency departments with episodic illnesses, acute injuries, and exacerbation of chronic disorders. We review recognition and assessment of pain in infants and children and discuss the manifestations of pain in children with chronic illness, recurrent pain syndromes, and cognitive impairment, including the difficulties of pain management in these patients. Non-pharmacological interventions, as adjuncts to pharmacological management for acute anxiety and pain, are described by age and development. We discuss the pharmacological management of acute pain and anxiety, reviewing invasive and non-invasive routes of administration, pharmacology, and adverse effects. Copyright © 2015 Elsevier Ltd. All rights reserved.The Lancet 06/2015; DOI:10.1016/S0140-6736(14)61686-X · 45.22 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.