Somatoform disorders in children and adolescents.

Somatization is common among children and adolescents. A consecutive series of 112 children and adolescents who fulfilled the ICD-10 clinical diagnostic criteria for somatoform disorders attended at a psychiatric consultation center were included in this study to delineate the pattern of presenting features and to find out associated abnormal psychosocial situations and disabilities. Out of 112 cases 52 were boys, 60 girls, of them 59 were children and 53 adolescents. Polysymptomatic presentation was commoner (92%) than monosymptomatic presentation (8%). Pain was the most prevalent symptom. Children showed significantly higher rates of abdominal complaints and adolescents showed higher rates of headaches. All cases reported an average of 14.21 somatic symptoms. Boys and girls reported an average of 13.75 and 14.61 somatic symptoms respectively and this difference between two groups was not significant. Whereas children reported an average of 12.66 somatic symptoms and adolescents reported an average of 15.94 somatic symptoms. The difference was significant. Differences were also found in the diagnostic categories of somatoform disorders. Girls reported higher rates of somatization disorder and persistent somatoform pain disorder than that of boys. Children reported higher rates of undifferentiated somatoform disorder and somatoform autonomic dysfunction. In contrast, adolescents reported higher rates of somatization disorder. Abnormal psychosocial situations were found to be associated with predisposition, onset, and course of the disorders in majority of the cases and most common was parental overprotection. Remarkable social impairments particularly, in the domains of academic and peer relationship were found among the cases. Findings suggest that somatoform disorders in children and adolescents are frequent in clinical practice. Better understanding of these disorders can promote early diagnoses and timely treatments and improve the quality of life by preventing negative consequences.

Depression in deliberate self harm patients.

One hundred consecutively admitted deliberate self-harm patients were studied. By using DSM III-R criteria for Major Depressive Episode (MDE) 38 were found to have major depressive disorder. Among them 27 were severe, 9 were moderate and only 2 were mild according to HRSD score which were entirely consistent with severity grading recorded by DSM III-R. Another 48 showed evidence of depressive symptoms which may be due to extreme subjective distress. All the depressed self-harm patients had depressed mood and almost all of them expressive somatization. Only 5 depressed self-harm patients were getting psychiatric treatment which indicate lack of awareness about the existence of depression among deliberate self-harm patients and poor referral service in the hospitals.