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Pain Somatoform Disorder Follow-up

  • Author: Dolores Protagoras-Lianos, MD; Chief Editor: Caroly Pataki, MD  more...
 
Updated: Oct 04, 2013
 

Further Outpatient Care

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  • Medical care for physical illness must be appropriate for diagnosed medical problems and requires judicious use of analgesics.
  • Close communication should be maintained between the primary care physician and the mental health professional. A team approach helps assure that all aspects of the child's health are being addressed.
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Further Inpatient Care

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  • Medical care for physical illness must be appropriate for diagnosed medical problems, and inpatient care should be limited to concerns about acute or chronic serious medical illness.
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Prognosis

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  • Outcome measure (physical symptoms): In the spectrum of physical symptoms, recurrent abdominal pain has been studied.
    • Seventy percent of patients continue to experience abdominal pain into adulthood; the symptom does not impair activity as in childhood but is more significant than in control subjects.[36]
    • Additional symptoms, such as headaches, develop in 30% of patients.
    • Multiple symptoms in childhood predict poorer adult outcome.
  • Outcome measure (functional and psychiatric status): In adulthood, individuals with a childhood history of recurrent abdominal pain are more likely than control subjects to have an anxiety disorder, hypochondriacal beliefs, or poor social functioning, and they are more likely to be treated with psychoactive medication.[37]
  • With psychological intervention, improved short-term and long-term outcomes have been reported.
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Patient Education

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  • Encourage the patient's acceptance of an alternative diagnosis of the pain other than severe illness.
  • Help the patient understand the role of psychological factors.
  • Help the patient discover strategies for coping with the symptoms.
  • Seek ways to reduce stressors that maintain the symptoms.
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Contributor Information and Disclosures
Author

Dolores Protagoras-Lianos, MD Former Director of Outpatient Department, Department of Pediatrics, Aghia Sophia Children's Hospital, Athens, Greece

Dolores Protagoras-Lianos, MD is a member of the following medical societies: American Academy of Pediatrics, Hellenic Paediatric Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

Chet Johnson, MD Professor of Pediatrics, Associate Director and Developmental-Behavioral Pediatrician, KU Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies; Assistant Dean, Faculty Affairs and Development, University of Kansas School of Medicine

Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

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