Somatization in pediatric primary care: Association with psychopathology, functional impairment, and use of services

Objective: To determine whether classification as pediatric "somatizers" id entifies a group of children and adolescents at high risk for psychopatholo gy, functional impairment, and frequent use of health services in a large, multisite study of pediatric primary care. Method: Parental reports of freq uent aches and pains and visits to the doctor for medically unexplained sym ptoms in children aged 4 to 15 years were used to construct a classificatio n of somatization in pediatric primary care. Affected and unaffected childr en and adolescents were compared on measures of demographics, family functi oning, psychopathology, functional status, and service use. Results: Classi fication as a somatizer was more common in adolescents, females, minority s ubjects, urban practices, nonintact families, and families with lower level s of parental education and was associated with heightened risk of clinicia n- and parent-identified psychopathology, family dysfunction, poor school p erformance and attendance, perceived health impairment, and more frequent u se of health and mental health services. Conclusions: Children classified a s pediatric somatizers are at heightened risk for psychiatric disorder, fam ily dysfunction, functional impairment, and frequent use of health services . Additional research is warranted, and clinicians should recognize the nee d for careful assessment and potential behavioral health referral in this p opulation.