Children and Adolescents with Medically Unexplained Symptoms: A Systematic Review of the Literature

Nonproductive thoughts, somatic symptoms and well-being in adolescence: testing the moderator role of age and gender in a representative study

“…The transition from primary/middle school to grammar school is a major social and educational change in the lives of our participants, which might be stressful and challenging. Since social stress is a known risk factor for somatic symptoms [ 44 ], this might explain our results. In addition, our study was cross-sectional, so we could not analyse the change in somatic symptoms individually, which could be (at least partly) accountable for the different results.…”

“…Although in this study we did not measure other variables such as pre-existing disease states [ 71 ], genetic and family factors [ 46 , 49 ], trauma [ 72 ], pain reactivity, temperament or personality traits [ 48 , 73 ] these factors were identified in the background of chronic fatigue and/or medically unexplained symptoms as well [ 44 ].…”

“…Although there are not too many theories that directly link nonproductive thoughts to somatic symptoms, we should note that the literature of somatic complaints and medically unexplained symptoms is robust. Previous studies indicated that these symptoms in children are monosymptomatic, but they became polysymptomatic over time [ 44 ]. For instance, headache and stomach ache are common in smaller children, while fatigue or other neurological symptoms are present during later adolescence [ 45 ].…”

The biopsychosocial model in paediatric clinical practice—An interdisciplinary approach to somatic symptom disorders

“…4 Patients may present with symptoms of persistent pain, fatigue or more complex somatic functional symptoms such as convulsions, syncopation, paralysis and sensory loss, as reflected in the literature and diagnostic manuals. [19][20][21][22][23] Paediatric SSD is associated with a number of negative psychological and social consequences, such as educational disruptions, social withdrawal, disrupted family functioning and can affect the child or adolescent's developmental trajectory. 4 These families have often had long-term contact with the healthcare services.…”

“…SSD are understood as severe and persistent physical symptoms seen in connection with psychological factors, and may or may not co‐occur with a specific medical condition 4 . Patients may present with symptoms of persistent pain, fatigue or more complex somatic functional symptoms such as convulsions, syncopation, paralysis and sensory loss, as reflected in the literature and diagnostic manuals 19–23 . Paediatric SSD is associated with a number of negative psychological and social consequences, such as educational disruptions, social withdrawal, disrupted family functioning and can affect the child or adolescent's developmental trajectory 4 …”