Pain Somatoform Disorder Treatment & Management

  • Author: Dolores Protagoras-Lianos, MD; Chief Editor: Caroly Pataki, MD   more...
 
Updated: Nov 21, 2011
 

Medical Care

  • Medical care for physical illness must be appropriate for the diagnosed medical problems and requires judicious use of analgesics.
  • Effective mental health treatment for children is family-centered. Goals for therapy include the following:
    • Gaining understanding of pain as a product of the interaction of physical and psychological factors
    • Improved family functioning
    • Increased assertiveness in victims of bullying
    • Learning strategies that produce some control over symptoms or reaction to pain, although symptoms may not be eradicated totally
    • Dealing successfully with anxiety generated by pain
    • Decreasing disability caused by pain
    • Limiting medical testing that is not helpful or necessary
  • Types of treatment include the following:
    • Counseling
    • Relaxation training (eg, progressive muscle relaxation, induced self-hypnosis)[6]
    • Behavioral methods (eg, behavioral-cognitive therapy)
    • Biofeedback
    • Family therapy (eg, focus on communication and appropriate responses)
  • Treat comorbid conditions (ie, anxiety, depression).
Next

Consultations

  • Subspecialist consultations based on suspicion of specific medical disorders include the following:
    • Neurologist (chronic headache pain)
    • Gastroenterologist (chronic abdominal pain)
  • Mental health specialist
Previous
Next

Activity

Encourage early gradual return to normal activity.

Previous
Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Dolores Protagoras-Lianos, MD  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

Disclosure: Nothing to disclose.

Specialty Editor Board

Chet Johnson  MD, Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies, University of Kansas; Professor and Chair of Pediatrics, University of Kansas Medical Center

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

Disclosure: Nothing to disclose.

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.

Carrie Sylvester, MD, MPH  Senior Child and Adolescent Psychiatrist, Sound Mental Health

Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD  Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

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

Disclosure: Nothing to disclose.

References

  1. APA. Diagnostic and Statistic Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Press; 1994.

  2. Busch V, Haas J, Crönlein T, Pieh C, Geisler P, Hajak G, et al. Sleep deprivation in chronic somatoform pain-effects on mood and pain regulation. Psychiatry Res. Jul 30 2011;[Medline].

  3. Goubert L, Eccleston C, Vervoort T, Jordan A, Crombez G. Parental catastrophizing about their child's pain. The parent version of the Pain Catastrophizing Scale (PCS-P): a preliminary validation. Pain. Aug 2006;123(3):254-63. [Medline].

  4. Tanaka H, Mollborg P, Terashima S, Borres MP. Comparison between Japanese and Swedish schoolchildren in regards to physical symptoms and psychiatric complaints. Acta Paediatr. Nov 2005;94:1661-66. [Medline].

  5. Soderholm JD, Perdue MH. Stress and gastrointestinal tract. II. Stress and intestinal barrier function. Am J Physiol Gastrointest Liver Physiol. Jan 2001;280:G7-G13. [Medline].

  6. Gottsegen D. Hypnosis for functional abdominal pain. Am J Clin Hypn. Jul 2011;54(1):56-69. [Medline].

  7. Campo JV, Di Lorenzo C, Chiappetta L, et al. Adult outcomes of pediatric recurrent abdominal pain: do they just grow out of it?. Pediatrics. Jul 2001;108(1):E1. [Medline]. [Full Text].

  8. Alfven G, Lindstrom A. A new method for the treatment of recurrent abdominal pain of prolonged negative stress origin. Acta Paediatr. Jan 2007;96:76-81. [Medline].

  9. Campo JV, Bridge J, Ehmann M, et al. Recurrent abdominal pain, anxiety, and depression in primary care. Pediatrics. Apr 2004;113(4):817-24. [Medline]. [Full Text].

  10. Drotar D, Wolraich ML, Felice ME. The Classification of Child and Adolescent Mental Diagnoses in Primary Care, Diagnostic and Statistical Manual for Primary Care (DSM-PC). Elk Grove, Ill: American Academy of Pediatrics; 1996.

  11. Ehlert U, Straub R. Physiological and emotional response to psychological stressors in psychiatric and psychosomatic disorders. Ann N Y Acad Sci. Jun 30 1998;851:477-86. [Medline].

  12. Ghandour RM, Overpeck MD, Huang ZJ, et al. Headache, stomachache, backache, and morning fatigue among adolescent girls in the United States: associations with behavioral, sociodemographic, and environmental factors. Arch Pediatr Adolesc Med. Aug 2004;158(8):797-803. [Medline].

  13. Hermann C, Zohsel K, Hohmeister J, Flor H. Cortical correlates of an attentional bias to painful and innocuous somatic stimuli in children with recurrent abdominal pain. Pain. Jun 2008;136(3):397-406. [Medline].

  14. Hjern A, Alfven G, Ostberg V. School stressors, psychological complaints and psychosomatic pain. Acta Paediatr. Jan 2008;97:112-117. [Medline].

  15. Kozlowska K, Rose D, Khan R, Kram S, Lane L, Collins J. A conceptual model and practice framework for managing chronic pain in children and adolescents. Harv Rev Psychiatry. Mar-Apr 2008;16:136-50. [Medline].

  16. Liakopoulou-Kairis M, Alifieraki T, Protagora D, et al. Recurrent abdominal pain and headache--psychopathology, life events and family functioning. Eur Child Adolesc Psychiatry. Jun 2002;11(3):115-22. [Medline].

  17. Petersen S, Brulin C, Bergström E. Recurrent pain symptoms in young schoolchildren are often multiple. Pain. Mar 2006;121(1-2):145-50. [Medline].

  18. Ramchandani PG, Hotopf M, Sandhu B, et al. The epidemiology of recurrent abdominal pain from 2 to 6 years of age: results of a large, population-based study. Pediatrics. Jul 2005;116(1):46-50. [Medline]. [Full Text].

  19. Ramchandani PG, Stein A, Hotopf M, et al. Early parental and child predictors of recurrent abdominal pain at school age: results of a large population-based study. J Am Acad Child Adolesc Psychiatry. Jun 2006;45(6):729-36. [Medline].

  20. Sanders D. Counseling for Psychosomatic Problems. London, England: Sage Publications; 1995.

  21. Santalahti P, Aromaa M, Sourander A, et al. Have there been changes in children's psychosomatic symptoms? A 10-year comparison from Finland. Pediatrics. Apr 2005;115(4):e434-42. [Medline]. [Full Text].

  22. Stein MT, Crow J, Abbott M, Tanner JL. Organic or psychosomatic? Facilitating inquiry with children and parents. J Dev Behav Pediatr. Oct 2004;25(5 Suppl):S97-101. [Medline].

  23. Vervoort T, Goubert L, Eccleston C, et al. Catastrophic Thinking About Pain is Independently Associated with Pain Severity, Disability, and Somatic Complaints in School Children and Children with Chronic Pain. J Pediatr Psychol. Aug 2006;31(7):674-83. [Medline].

  24. Walker LS, Smith CA, Garber J, Claar RL. Appraisal and coping with daily stressors by pediatric patients with chronic abdominal pain. J Pediatr Psychol. Mar 2007;32:206-216. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.