The Investigation of Atypical Psychosomatic Illness

Abstract

The experience of 12 children with atypical psychosomatic illness who presented considerable diagnostic difficulties is described. All patients were admitted to the hospital, and using a team approach, it was possible to make a confident diagnosis. No organic disease was identified, and a psychosomatic diagnosis was made. In general, atypical symptoms and signs, false-positive investigations, and differing medical opinion had compounded the diagnostic difficulties. The value of the observations made by ward staff of the childrens' symptoms and behavior is stressed.

"The menace of psychiatry": does it still ring a bell?

“…Children who have been badly injured or burned, or whose parents are seriously ill (or have died22) in adult wards of the hospital often have mental health needs, usually neglected. Patients with disabling symptoms not fully explained by organic pathology — somatisation and conversion disorders,23 confusional states, habit disorders, unusual seizures or pains, fatigue and refusal syndromes, eating and elimination disorders — provoke familiar splits between colleagues 24. Careful joint work is required.…”

Pediatric Team Meetings: The Mental Health Consultant’s Role

“…This type of team meeting also focuses on patients whose illness has a major psychosocial component, such as conversion disorder or child abuse. For example, the team approach has been shown to be effective in establishing a diagnosis in children with atypical psychosomatic illness (Dunger et al, 1986). The composition of this type of team is generally the primary physician, nurse, social worker and mental health consultant.…”