Abstract
Specialist paediatric services manage a variety of presentations of functional somatic symptoms. We aimed to describe the presentation and management of children and adolescents with somatic symptom and related disorders (SSRDs) requiring admission to a tertiary children’s hospital with the objective of informing the development of a local clinical pathway. Patients admitted to any hospital department from May 2016 to November 2017 were identified through an electronic medical record (EMR)-linked diagnosis of SSRD. Each record was reviewed for demographic details and admission histories. The frequency of interspecialty consultations and multidisciplinary team (MDT) family meetings were recorded. One hundred twenty-three patients with SSRD were admitted on 203 occasions to 17 different departments. The median (range) age was 14.3 (7.3–18.3) years. Interspecialty consultations occurred in 84.6% of patients, and MDT family meetings occurred in 18.9% patients. SSRD was diagnosed as an inpatient in 79.9% patients, yet only 40.7% of patients, including those with multiple admissions, had SSRD recorded as a discharge diagnosis.
Conclusion: Despite high rates of consultation with hospital teams, the frequency of MDT family meetings was low, and less than half the patients had SSRD documented at discharge. This affirms the value of developing a local clinical pathway.
What is Known • Functional somatic symptoms are commonly seen in children and adolescents. • Few studies have explored the reach of functional somatic symptoms across a tertiary paediatric hospital; the majority of inpatient studies have focused on a limited set of disorders or cases referred to psychiatry departments. What is New • Symptoms that spanned multiple body systems were the most common presentation of SSRDs in admitted children and adolescents. • Somatic symptom disorders are less likely to be recorded as a discharge diagnosis compared with functional neurological symptom disorder. |
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Available on written request to corresponding author.
Change history
17 December 2020
A Correction to this paper has been published: https://doi.org/10.1007/s00431-020-03911-1
Abbreviations
- DSM-5:
-
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
- EMR:
-
Electronic medical record
- FND:
-
Functional neurological symptom disorder
- MDT:
-
Multidisciplinary team
- RCH:
-
Royal Children’s Hospital
- SSD:
-
Somatic symptom disorder
- SSRD:
-
Somatic symptom and related disorder
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Ahuva Segal and Professor David Coghill are acknowledged for their assistance.
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AW and SMS conceptualised the study and contributed to the study design. AW extracted all data from the patient’s EMR into a de-identified database. AW and SMS drafted the paper. All authors critically reviewed the paper, approved the version published and agree to be accountable for the study.
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The study was approved by The Royal Children’s Hospital Melbourne Human Research Ethics Committee (reference number LNR/17/RCHM/402).
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The original online version of this article was revised: The above article contained some grammatical errors on the body. Some texts were changed to “were” instead of “was”, “disorders” instead of “disorder”, “appears” instead of “appear” and the presentation of Table entries under their respective headings were also arranged accordingly.
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Wiggins, A., Court, A. & Sawyer, S.M. Somatic symptom and related disorders in a tertiary paediatric hospital: prevalence, reach and complexity. Eur J Pediatr 180, 1267–1275 (2021). https://doi.org/10.1007/s00431-020-03867-2
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DOI: https://doi.org/10.1007/s00431-020-03867-2