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. 2006 May;15(2):64-74.

An algorithm for defining somatization in children

Inna Postilnik  1 , Howard D Eisman, Rebecca Price, Joshua Fogel
Affiliations

An algorithm for defining somatization in children

Inna Postilnik et al. J Can Acad Child Adolesc Psychiatry. 2006 May.

Abstract
in English, French

Introduction: Defining somatization in pediatric populations presents a unique challenge, because DSM-IV somatization criteria may be inadequate for identifying a child with somatization. Two approaches exist. Child somatization has frequently been rooted in a questionnaire model, focusing on child or parent responses to assess how well a child conforms to a specific mental health profile. Others use a medical diagnosis model, designating a child with somatization as those for whom a limited number of medical measures have failed to reveal a pathological source of symptoms.

Method: We incorporate concepts based upon a literature review from January 1994 to June 2005 of PubMed, PsycINFO, and CINAHL on classification and diagnosis of somatization in children ages 6 to 12. Our goal is to understand in depth the topic and suggest a way to better understand and classify somatization in children.

Results: We incorporate an integrative approach toward defining child somatization and propose an algorithm to step-by-step classify children with somatic symptoms into three distinct groups: sick, somatizers, and well. This approach includes information from self-report questionnaire, physician questionnaire, and the child's medical chart.

Conclusion: This new algorithm suggests an approach for differentiating primary care pediatric clinic visitors into three distinct groups. Although used in clinical practice, empirical validation is necessary to further validate this algorithm.

Introduction: Il est particulièrement difficile de définir la somatisation chez les patients pédiatriques parce que les critères de somatisation définis dans le DSM-IV ne permettent pas toujours de reconnaître la somatisation chez les enfants. Deux approches coexistent. Dans la première approche, la somatisation fait l’objet d’un questionnaire, les réponses de l’enfant ou du parent servant à évaluer dans quelle mesure l’enfant entre dans un profil spécifique. La deuxième approche fait appel à un diagnostic médical, qui définit un enfant qui somatise comme un enfant chez lequel un certain nombre d’interventions médicales n’ont pas réussi à mettre à jour la source pathologique des symptômes.

Méthode: Nous utilisons des concepts basés sur une analyse des revues PubMed, PsycINFO et CINAHL publiées entre juin 1994 et juin 2005 qui traitent du classement et des diagnostics de somatisation chez les enfants âgés de 6 à 12 ans. Notre objectif est d’approfondir, de définir et de catégoriser la somatisation chez les enfants.

Résultats: Nous utilisons une approche intégrale pour définir la somatisation chez l’enfant et proposons un algorithme permettant de classer méthodiquement les enfants qui présentent des symptômes somatiques dans trois groupes distincts: enfants malades, enfants qui somatisent et enfants bien portants. Cette approche prend en compte les informations recueillies au moyen du questionnaire autoadministré, du questionnaire du médecin, ainsi que les données figurant au dossier médical de l’enfant.

Conclusion: Ce nouvel algorithme propose une approche qui classe dans trois groupes distincts les enfants qui fréquentent les cliniques pédiatriques. Bien que cet algorithme soit utilisé en pratique clinique, il doit être validé empiriquement.

Keywords: algorithms; child psychiatry; child psychology; classification; diagnostic techniques and procedures; pediatrics; somatoform disorders.

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Figures

Figure 1
Figure 1
Flowchart outlining an integrative methodological approach to classifying children as medically ill, somatizers, or well.
Figure 2
Figure 2
Flowchart detailing an algorithm for classifying children as medically ill, somatizers, or well.
See this image and copyright information in PMC

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