Pain Somatoform Disorder Follow-up

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

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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