SOMATIZATION IN CHILDREN AND ADOLESCENTS

Objective: To review the empirical literature on somatization in the p ediatric age group, emphasizing prevalence, influence on health care u tilization, issues in the development of somatization, comorbidity wit h other psychiatric disorders, assessment, and treatment. Method: One hundred nineteen studies and reports addressing medically unexplained somatic symptoms in children and adolescents were compiled via MEDLINE search and extensive cross-referencing. All available controlled stud ies were included, as were selected case reports and collections of ca ses. Selected citations from the adult literature were chosen for rele vance to pediatric somatization. Results: Recurrent, medically unexpla ined physical symptoms are common in the pediatric age group, are ofte n associated with other psychiatric symptoms, and may represent a comm on presentation of psychiatric disorder in the primary care setting. D SM-III-R-defined somatization disorder is rare, and pseudoneurological symptoms are unusual. Patients may be at risk for potentially dangero us, costly, and unnecessary medical investigations and treatments, and they may excessively utilize health care services. Conclusion: Our cu rrent understanding of pediatric somatization and its consequences is limited. Collaboration between mental health professionals and primary health care providers is essential. Consistent terminology, developme ntally appropriate classification, and systematic future research will be necessary for the development of successful prevention and treatme nt strategies.