There are several types of somatic symptom and related disorders.
Symptoms may resemble those of a neurologic disorder (such as paralysis or loss of vision) or be vague (such as headache and nausea), or children may be obsessed with an imagined defect or be convinced that they have a serious disease.
After doing tests to exclude physical disorders that could cause the symptoms, doctors base the diagnosis on symptoms.
Individual and family psychotherapy, often using cognitive-behavioral techniques, can help.
Symptoms and treatment of somatic symptom and related disorders are very similar to those of anxiety disorders Overview of Anxiety Disorders in Children and Adolescents Anxiety disorders are characterized by fear, worry, or dread that greatly impairs the ability to function and is out of proportion to the circumstances. There are many types of anxiety disorders... read more .
Somatic symptom and related disorders include the following:
Conversion disorder Functional Neurological Symptom Disorder In functional neurological symptom disorder, physical symptoms that resemble those of a nervous system (neurologic) disorder develop. The symptoms can follow mental factors such as conflicts... read more : Symptoms resemble those of a nervous system disorder. Children may have a paralyzed arm or leg, become deaf or blind, or have shaking that may resemble a seizure. The symptoms are commonly triggered by mental factors such as conflicts or other stresses.
Factitious disorder imposed on another (previously referred to as Munchausen syndrome by proxy) Factitious Disorder Imposed on Another Factitious disorder imposed on another is falsifying or producing symptoms of a physical or psychologic disorder in another person. It is usually done by caregivers (typically parents) to someone... read more : Caregivers (typically a parent) intentionally falsify or produce physical symptoms in a child. For example, they may add blood or other substances to urine specimens to simulate a urine infection.
Factitious disorder imposed on self Factitious Disorder Imposed on Self Factitious disorder is pretending to have or producing physical or psychologic symptoms for no apparent external reason. The cause is unknown, but stress and a severe personality disorder may... read more : The child may pretend to have physical symptoms or do something to themselves to produce physical symptoms.
Illness anxiety disorder Illness Anxiety Disorder Illness anxiety disorder is preoccupation with having or acquiring a serious disorder. People are so worried that they are or might become ill that they become very distressed and have difficulty... read more : Children are extremely worried that they are ill or might become ill. They may or may not have physical symptoms or an actual medical disorder. If they do have symptoms or a disorder, their worries are out of proportion to the seriousness of the situation. They may also feel anxious and depressed.
Somatic symptom disorder Somatic Symptom Disorder Somatic symptom disorder is characterized by one or more chronic physical symptoms accompanied by significant and out-of-proportion levels of distress, worries, and difficulty in daily functioning... read more : Children may develop many symptoms or only one severe symptom, typically pain. Symptoms may be specific (such as pain in the abdomen) or vague (such as fatigue). Any part of the body may be the focus of concern. Children worry excessively about these symptoms and their possible consequences.
Somatic symptom and related disorders are equally common among young boys and young girls but are more common among adolescent girls than adolescent boys.
(See also Overview of Somatic Symptom and Related Disorders Overview of Somatic Symptom and Related Disorders Somatic symptom and related disorders are mental health disorders characterized by an intense focus on physical (somatic) symptoms that causes significant distress and/or interferes with daily... read more in adults.)
Symptoms
Children with one of these disorders may have a number of symptoms, including pain, difficulty breathing, and weakness. Children may or may not have another disorder.
Often children develop physical symptoms when another family member is seriously ill. Sometimes the symptoms are normal body sensations or discomfort that are misinterpreted. These physical symptoms are thought to develop unconsciously in response to a psychologic stress or problem (see sidebar Mind and Body Mind and Body 
). The symptoms are not consciously fabricated, and children are actually experiencing the symptoms they describe.
Children are focused on their health and/or symptoms. They worry about the seriousness of their symptoms and/or spend an excessive amount of time and energy on activities related to their health or symptoms.
Diagnosis
A visit with a doctor or behavioral health specialist
Sometimes questionnaires about symptoms
Physical examination and sometimes tests to rule out other disorders
Doctors ask children about their symptoms and do a physical examination and sometimes tests to make sure that children do not have a physical disorder that could account for the symptoms. However, extensive laboratory tests are generally avoided because they may further convince children that a physical problem exists and unnecessary diagnostic tests may themselves traumatize children.
For one of these disorders to be diagnosed, symptoms must be distressing or interfere with daily functioning, and children must be excessively concerned about their health and/or symptoms in thoughts and actions.
If no physical problem can be identified, doctors may use standardized mental health tests to help determine whether symptoms are due to a somatic symptom or related disorder. Doctors also talk to the children and family members to try to identify underlying psychologic problems or difficult family relationships.
Treatment
Psychotherapy
A rehabilitation program to restore a normal routine
Sometimes medications to relieve symptoms
Children may balk at the idea of visiting a psychotherapist because they think their symptoms are purely physical. However, individual and family psychotherapy, often using cognitive-behavioral techniques, can help children and family members recognize patterns of thought and behavior that perpetuate the symptoms. Therapists may use hypnosis, biofeedback, and relaxation therapy.
Psychotherapy Psychotherapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment... read more is usually combined with a rehabilitation program that aims to help children get back into a normal routine. It can include physical therapy, which has the following benefits:
It may treat actual physical effects, such as reduced mobility or loss of muscle, caused by a somatic symptom or related disorder.
It makes children feel as if something concrete is being done to treat them.
It enables children to participate actively in their treatment.
Having a primary care doctor who supports them, sees them regularly, and coordinates all their care is also important.
Medications, such as a type of antidepressant called selective serotonin reuptake inhibitors Selective serotonin reuptake inhibitors (SSRIs) Agomelatine, a new type of antidepressant, is a possible treatment for major depressive episodes. Several types of drugs can be used to treat depression: Selective serotonin reuptake inhibitors... read more (SSRIs), may be used to relieve pain or the anxiety or depression that can accompany these disorders.
