13 Apr Somatic Manifestation of Psychiatric Symptoms in Children
Screening and early detection positively influence treatment outcomes for young children. Early identification promotes more rapid treatment interventions, allowing youth to recover and benefit from their education, develop healthy relationships, access employment, and prevent the onset of more chronic and debilitating conditions as adults. The American Academy of Pediatrics supports the position of early screening and identification, resulting in improved standards for screening children. A longitudinal study reported in 2015 cites that adults who experienced untreated psychiatric symptoms as children had three times higher odds of adverse outcomes in adulthood, thus highlighting the need for continued focus on early identification.
Educators and school mental health professionals often are in a frontline position to notice warning signs and symptoms of the onset of a psychiatric illness in youth. These warning signs often will include somatic symptomatology. A 2000 study in Interpersonal and Biological Processes found that somatic complaints were prevalent for over 69% of youth diagnosed with mental health conditions. Children with an anxiety or depressive disorder had more frequent physical symptoms than those with a different type of psychiatric illness. Younger children more often complained of gastrointestinal symptoms, while older children more frequently complained of headaches.
Another study reported in the Child and Adolescent Psychiatry and Mental Health journal in 2018 found that somatic symptoms in adolescence predicted severe adult mental illness. The researchers concluded that youth who complain of somatic symptoms need screening for anxiety and depression, early intervention, and ongoing care to help mitigate the risk of severe mental illness in adulthood.
The Journal of the American Academy of Child and Adolescent Psychiatry researched the connection between somatic complaints and different types of psychiatric illness. The researchers concluded differences in how specific psychiatric illnesses impacted physical symptoms based on gender, illness type, and complaint-specific associations. Girls with depression and anxiety were likelier to report somatic complaints, whereas boys with conduct disorders were likelier to show a relationship between physical symptoms and psychopathology. Headaches and GI symptoms were more prevalent in girls with anxiety disorders. Boys with oppositional defiant disorder and attention-deficit hyperactivity disorder more often complained of GI symptoms. Musculoskeletal pains were associated with depression in both girls and boys. The research suggests differences in the psychobiological processes underlying these associations in boys and girls.
Over the past few decades, research has provided evidence of the association between somatic and psychiatric symptoms. Somatic symptoms that may represent underlying psychopathology include migraines or headaches, pain, insomnia, stomachache, nausea, vomiting, diarrhea, constipation, and tiredness. These symptoms can be easily missed as signs of an underlying mental health concern.
In educational settings and clinical practice, questions about somatic and psychiatric symptoms should also be addressed in children with frequent somatic concerns. Children frequently complaining of physical symptoms should prompt school professionals to discuss additional mental health evaluation with parents. Clinical recommendations for school psychologists and administrators include screening children and adolescents with persistent complaints of headaches, stomach aches, or musculoskeletal pains for psychiatric disorders with an awareness that these may suggest underlying psychopathology associated with somatic complaints.