Somatisation in children

Question 1

What is somatisation in children (RF, Sx)

Answer 1

its the comminication of emotional distress, troubled relationships, personal predicatments through BODILY sx
RF - peak age at 9, males

Sx
presents differently with age -
Reccurrent abdo pain -sharp and quick, in the center of abdomen, no other sign
peak age 9
10% of school age children, no organic cause (exclusion)
Apleys rule - the further from the umbilicus the more likely its organic cause

recurrent headaches -peak age 12
Limb pain, aching muscles, fatigue, neuro signs >12yo

Question 2

Ix and Mx of somatisation in children

Answer 2

Ix -diagnosis of exclusion so be thorough
Full body exam
Full history, especially with social hx - school, friends, family, timeline of pain (when it happens)
can be done without parents
school reports useful

Mx
1st line - promote communication between fam and child (and shcool)
pain coping skills -relaxation, meditation etc
DONT ENCOURAGE SKIPPING SCHOOL FOR PAIN
social prescribing etc
2nd line - if 1st line fails, serious fam dysf, impaired functioning -> CAMHS