Treatment of functional impairment in severe somatoform pain disorder: A case example

Objective: To describe the assessment and treatment of severe functional im pairment in a young female adolescent with somatoform pain disorder. Methods: Treatment included an inpatient hospital admission using a rehabil itation approach and behavior modification program. Standardized assessment of functional impairment and health-related quality of life was performed at baseline and follow-up. Diagnostic evaluation and treatment costs were c omputed using insurance and hospital billing data. Results: Pre-/postintervention measures of functional disability indicated significant improvement in physical and psychosocial functioning in everyda y activities. Although costly, the inpatient admission decreased frequent h ealth care use over the short term. Conclusions: Delay in diagnosis of somatoform disorders may seriously exten d children's disability and require more intensive treatment. Functional di sability is a critical measure of treatment outcome in children with severe somatoform disorder. Future research concerning interventions for children with a broad range of recurrent and chronic pain symptoms can be strengthe ned through a focus on reducing functional disability.