Somatic symptoms are often common causes for medical consultation. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Five principal groups of drugs such as tricyclic antidepressants (TCA), serotonin reuptake inhibitors (SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics and herbal medication are systematically studied. The evidence indicates that all five groups are effective in a wide range of disorders. All classes of antidepressants seem to be effective against somatoform and related disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder (BDD), and SNRIs appear to be more effective than other antidepressants when pain is the predominant symptom. Research leaves many unanswered questions regarding dosing, duration of treatment, sustainability of improvement in the long term and differential response to different class drugs. Further studies need to focus on treatments based on clinical features/psychopathology and collaborative research with other specialists in understanding the relation of somatic symptom disorders and functional somatic syndromes (FSS), and comparing psychotropics and non-psychotropics and combinations treatments.

We conclude that although many patients would like to know the truth, the rights of those who do not wish to know should also be respected. Therefore the diagnosis of mental disorder should not be routinely disclosed, but mental health professionals should take into consideration their patients' preferences and act appropriately to their choice. (Int J Psych Clin Pract 2002; 6: 103-106).

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We report the successful treatment of selective mutism in a child with pervasive developmental disorder (PDD). There are several studies and case reports in which Fluoxetine has been reported effective in diminishing adult social anxiety and increasing speech in public settings. The literature is much smaller for children. The efficacy of fluoxetine supports the argument that selective mutism is a developmental equivalent of social anxiety disorder. To our knowledge this is the first description of successful treatment when the selective mutism is complicated by PDD.

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