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. 2007;16(3):124-31.

Empirical testing of an algorithm for defining somatization in children

Howard D Eisman  1 , Joshua Fogel, Regina Lazarovich, Inna Pustilnik
Affiliations

Empirical testing of an algorithm for defining somatization in children

Howard D Eisman et al. J Can Acad Child Adolesc Psychiatry. 2007.

Abstract
in English, French

Introduction: A previous article proposed an algorithm for defining somatization in children by classifying them into three categories: well, medically ill, and somatizer; the authors suggested further empirical validation of the algorithm (Postilnik et al., 2006). We use the Child Behavior Checklist (CBCL) to provide this empirical validation.

Method: Parents of children seen in pediatric clinics completed the CBCL (n=126). The physicians of these children completed specially-designed questionnaires. The sample comprised of 62 boys and 64 girls (age range 2 to 15 years). Classification categories included: well (n=53), medically ill (n=55), and somatizer (n=18). Analysis of variance (ANOVA) was used for statistical comparisons. Discriminant function analysis was conducted with the CBCL subscales.

Results: There were significant differences between the classification categories for the somatic complaints (p=<0.001), social problems (p=0.004), thought problems (p=0.01), attention problems (0.006), and internalizing (p=0.003) subscales and also total (p=0.001), and total-t (p=0.001) scales of the CBCL. Discriminant function analysis showed that 78% of somatizers and 66% of well were accurately classified, while only 35% of medically ill were accurately classified.

Conclusion: The somatization classification algorithm proposed by Postilnik et al. (2006) shows promise for classification of children and adolescents with somatic symptoms.

Introduction: Un article précédent proposait un algorithme destiné à définir la somatisation chez les enfants qui étaient classés dans trois catégories : enfants en bonne santé, enfants malades, et enfants qui somatisent. Les auteurs de cet article estimaient nécessaire de valider empiriquement l’algorithme (Postilnik et al., 2006) présenté. Nous avons utilisé la Child Behavior Checklist (CBCL) pour procéder à cette validation.

Méthodologie: Les parents des enfants vus en clinique pédiatrique ont rempli la CBCL (n=126), tandis que les médecins remplissaient un questionnaire spécial. L’échantillon consistait en 62 garçons et 64 filles âgés de 2 à 15 ans. Les sujets ont été classés en trois catégories : enfants bien portants (n=53), enfants malades (n=55), et enfants qui somatisent (n=18). L’analyse de variance (ANOVA) a été utilisée à des fins de comparaison statistique. L’analyse discriminante a porté sur les sous-échelles de la CBCL.

Résultats: On constate des écartssignificatifs entre les catégories des sous-échelles relatives aux plaintes de nature somatique (p=<0,001), problèmes de nature sociale (p=0,004), problèmes au niveau de la pensée (p=0,01), déficits d’attention (0,006), problèmes internalisés (p=0,003), et aussi des différences importantes par rapport au total (p=0,001), et au total T (p=0,001). L’analyse discriminante a permis de constater que 78 % des enfants qui somatisaient et 66 % des enfants bien portants étaient classés dans la bonne catégorie, contre 35 % seulement des enfants malades.

Conclusion: L’algorithme d’évaluation de la somatisation chez les enfants et les adolescents qui est proposé par Postilnik et al. (2006) a un avenir prometteur.

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

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Figures

Figure 1
Figure 1
Flowchart detailing an algorithm for classifying children as medically ill, somatizers, or well. Note: CBCL = Child Behavior Checklist, CHRCR = Child’s Health Record Chart Review, PQ = Physician’s Questionnaire. Original figure reprinted from Postilnik et al., 2006 with permission. It also can be viewed in the original article freely available at http://www.cacap-acpea.org/onottaca/doc.nsf/files/4D9AC1A899B10618872571A800797BF6/$file/2006MayAlgorithmforDefiningSomatization.pdf
See this image and copyright information in PMC

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