Somatic syndromes: assessment and treatment for children and adolescents

Up to one-third of children and adolescents experience recurring somatic health complaints which may occur at a single or multiple sites, for which no well-defined physical disorder is identified to explain the constellation of symptoms. The most common somatic complaints in youth include recurring headaches, abdominal pain, nausea, dizziness, and/or fatigue. In the past decade, a rapidly evolving body of literature has focused on evaluating the characteristics, prevalence, assessment, and psychological treatment considerations for children and adolescents with somatic syndromes given that a high proportion of these children and adolescents also experience comorbid elevated anxiety and/or depressive symptoms. In this chapter, an overview of common terminology used in this field is outlined along with the characteristics and prevalence of somatic syndromes in children and adolescents. An outline of biopsychosocial models is presented along with diagnostic frameworks and assessment methods recommended to screen and assess children and adolescents presenting with recurrent somatic health complaints. An evaluation of published systematic and meta-analytic reviews which have evaluated psychotherapy interventions for managing somatic syndromes in children and adolescents is also presented. Cognitive-behavioral therapy (CBT) based interventions show the most promising evidence to date and are recommended to be considered as part of a multidisciplinary care plan to facilitate children and adolescents presenting with distressing somatic complaints to mental health services. The chapter concludes with a discussion of clinical and research implications for clinicians and researchers working with youth presenting with somatic syndromes.