Somatic symptom and related disorders in pediatric patients: Associations with parent psychiatric and substance use histories

Abstract

Parental response to pediatric patients with somatic symptom and related disorders (SSRDs) can impact symptom presentation. However, little is known about the impact of parent psychiatric and substance use disorder (SUD) history on the functional status and medical healthcare utilization of patients with SSRDs. The current study explored the associations between parent psychiatric & SUD history and patient somatic symptoms, functional disability, and hospital course in a medically hospitalized sample of pediatric patients with SSRDs. The electronic medical records of 375 pediatric patients with SSRDs, ages 5 to 18, admitted at a tertiary pediatric hospital were retrospectively reviewed. Parent psychiatric histories were identified in 45.1% of the sample. Parent SUD history and maternal psychiatric history were associated with more patient reported somatization. Parent psychiatric and SUD history were not associated with pediatric patients’ level of functional disability or healthcare utilization during admission, including admission length, number of tests, and number of consultations obtained. This study has implications regarding reduction of potential stigma towards parents with psychiatric or SUD histories whose children are hospitalized with SSRDs. While such histories may provide insights regarding somatization presentation of pediatric patients with these disorders, it may not necessarily impact level of functional disability or hospital course.

Keywords

Pediatric somatization somatic symptoms parent mental health substance use disorders pediatrics

Get full access to this article

View all access options for this article.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). American Psychiatric Publishing.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Bedard-Thomas

Bujoreanu

Choi

Ibeziako

(2018). Perception and impact of life events in medically hospitalized patients with somatic symptom and related disorders. Hospital Pediatrics, 8(11), 699–705. https://doi.org/10.1542/hpeds.2017-0197

Bettini

E. A.

Moore

Wang

Hinds

P. S.

Finkel

J. C.

(2018). Association between pain sensitivity, central sensitization, and functional disability in adolescents with joint hypermobility. Journal of Pediatric Nursing, 42, 34–38. https://doi.org/10.1016/j.pedn.2018.06.007

Bujoreanu

Randall

Thomson

Ibeziako

(2014). Characteristics of medically hospitalized pediatric patients with somatoform diagnoses. Hospital Pediatrics, 4(5), 283–290. https://doi.org/10.1542/hpeds.2014-0023

Burmeister

McInnis

M. G.

Zöllner

(2008). Psychiatric genetics: Progress amid controversy. Nature Reviews: Genetics, 9(7), 527–540. https://doi.org/10.1038/nrg2381

Campo

J. V.

Bridge

Lucas

Savorelli

Walker

DiLorenzo

Satish

(2007). Physical and emotional health of mothers of youth with functional abdominal pain. Archives of Pediatrics and Adolescent Medicine, 161(2), 131–137. https://doi.org/10.1001/archpedi.161.2.131

Campo

J. V.

Jansen-McWilliams

Comer

D. M.

Kelleher

K. J.

(1999). Somatization in pediatric primary care: Association with psychopathology, functional impairment, and use of services. Journal of the American Academy of Child and Adolescent Psychiatry, 38(9), 1093–1101. https://doi.org/10.1097/00004583-199909000-00012

Claar

R. L.

Simons

L. E.

Logan

D. E.

(2008). Parental response to children’s pain: The moderating impact of children’s emotional distress on symptoms and disability. Pain, 138(1), 172–179. https://doi.org/10.1016/j.pain.2007.12.005

10.

Claar

R. L.

Walker

L. S.

(2006). Functional assessment of pediatric pain patients: Psychometric properties of the functional disability inventory. Pain, 121(1–2), 77–84. https://doi.org/10.1016/j.pain.2005.12.002

11.

Corrigan

P. W.

Mittal

Reaves

C. M.

Haynes

T. F.

Han

Morris

Sullivan

(2014). Mental health stigma and primary health care decisions. Psychiatry Research, 218(1–2), 35–38. https://doi.org/10.1016/j.psychres.2014.04.028

12.

Dengler-Crish

C. M.

Horst

S. N.

Walker

L. S.

(2011). Somatic complaints in childhood functional abdominal pain are associated with functional gastrointestinal disorders in adolescence and adulthood. Journal of Pediatric Gastroenterology and Nutrition, 52(2), 162–165. https://doi.org/10.1097/MPG.0b013e3181ec1d2e

13.

Faul

Erdfelder

Buchner

Lang

A. G.

(2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. https://doi.org/10.3758/BRM.41.4.1149

14.

Faul

Erdfelder

Lang

A.G.

Buchner

(2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146

15.

Garber

Walker

L. S.

Zeman

(1991). Somatization symptoms in a community sample of children and adolescents: Further validation of the Children’s Somatization Inventory. Psychological Assessment, 3(4), 588–595. https://doi.org/10.1037/1040-3590.3.4.588

16.

Graesholt-Knudsen

Skovgaard

A. M.

Jensen

J. S.

Rask

C. U.

(2017). Impact of functional somatic symptoms on 5-7-year-olds’ healthcare use and costs. Archives of Disease in Childhood, 102(7), 617–623. https://doi.org/10.1136/archdischild-2016-311808

17.

Henderson

Noblett

Parke

Clement

Caffrey

Gale-Grant

Schulze

Druss

Thornicroft

(2014). Mental health-related stigma in health care and mental health-care settings. The Lancet Psychiatry, 1(6), 467–482.

18.

Ibeziako

Choi

Randall

Bujoreanu

(2016). Bullying victimization in medically hospitalized patients with somatic symptom and related disorders: Prevalence and associated factors. Hospital Pediatrics, 6(5), 290–296. https://doi.org/10.1542/hpeds.2015-0207

19.

IBM Corporation. (2016). IBM SPSS Statistics for Windows, Version 24.0. IBM Corp.

20.

Imbierowicz

Egle

U. T.

(2003). Childhood adversities in patients with fibromyalgia and somatoform pain disorder. European Journal of Pain, 7(2), 113–119. https://doi.org/10.1016/S1090-3801(02)00072-1

21.

Janicke

Finney

Riley

(2001). Children’s health care use: A prospective investigation of factors related to care-seeking. Medical Care, 39(9), 990–1001. https://doi.org/10.1097/00005650-200109000-00009

22.

Kozlowska

Nunn

K. P.

Rose

Morris

Ouvrier

R. A.

Varghese

(2007). Conversion disorder in Australian pediatric practice. Journal of the American Academy of Child and Adolescent Psychiatry, 46(1), 68–75. https://doi.org/10.1097/01.chi.0000242235.83140.1f

23.

Levy

R. L.

Whitehead

W. E.

Walker

L. S.

Von Korff

Feld

A. D.

Garner

Christie

(2004). Increased somatic complaints and health care utilization in children: Effects of parent IBS status and parent response to gastrointestinal symptoms. American Journal of Gastroenterology, 99(12), 1–10. https://doi.org/10.1111/j.1572-0241.2004.40478.x

24.

Lipowski

Z. J.

(1988). Somatization: The concept and its clinical application. American Journal of Psychiatry, 145(11), 1358–1368. https://doi.org/10.1176/ajp.145.11.1358

25.

Loiselle

K. A.

Lee

J. L.

Gilleland

Campbell

Simpson

Johnson

Dooley

Blount

R. L.

(2012). Factors associated with healthcare utilization among children with noncardiac chest pain and innocent heart murmurs. Journal of Pediatric Psychology, 37(7), 817–825. https://doi.org/10.1093/jpepsy/jss055

26.

Maybery

Reupert

Patrick

Goodyear

Crase

(2009). Prevalence of children whose parents have a mental illness. Psychiatric Bulletin, 33(1), 22–26. https://doi.org/10.1192/pb.bp.107.018861

27.

Mulvaney

Lambert

E. W.

Garber

Walker

L. S.

(2006). Trajectories of symptoms and impairment for pediatric patients with functional abdominal pain: A 5-year longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 45(6), 737–44. https://doi.org/10.1097/10.chi.0000214192.57993.06.

28.

Olfson

Marcus

S. C.

Druss

Pincus

H. A.

Weissman

M. M.

(2003). Parental depression, child mental health problems, and health care utilization. Medical Care, 41(6), 716–721. https://doi.org/10.1097/01.MLR.0000064642.41278.48

29.

Schulte

I. E.

Petermann

(2011). Somatoform disorders: 30 years of debate about criteria! What about children and adolescents? Journal of Psychosomatic Research, 70(3), 218–228. https://doi.org/10.1016/j.jpsychores.2010.08.005

30.

Shaffer

Gould

M. S.

Brasic

Ambrosini

Fisher

Bird

Aluwahlia

(1983). A Children’s Global Assessment Scale (CGAS). Archives of General Psychiatry, 40(11), 1228–1231. https://doi.org/10.1001/archpsyc.1983.01790100074010

31.

Smith

M. S.

Martin-Herz

S. P.

Womack

W. M.

Marsigan

J. L.

(2003). Comparative study of anxiety, depression, somatization, functional disability, and illness attribution in adolescents with chronic fatigue or migraine. Pediatrics, 111(4 Pt 1), e376–e381. http://pediatrics.aappublications.org/content/111/4/e376

32.

Stone

E. M.

Chen

L. N.

Daumit

G. L.

Linden

McGinty

E. E.

(2019). General medical clinicians’ attitudes toward people with serious mental illness: A scoping review. The Journal of Behavioral Health Services & Research, 46(4), 656–679.

33.

Van Oudenhove

Levy

R. L.

Crowell

M. D.

Drossman

D. A.

Halpert

A. D.

Keefer

Lackner

J. M.

Murphy

T. B.

Naliboff

B. D.

Naliboff

B. D.

(2016). Biopsychosocial aspects of functional gastrointestinal disorders: How central and environmental processes contribute to the development and expression of functional gastrointestinal disorders. Gastroenterology, 150(6), 1355–1367. https://doi.org/10.1053/j.gastro.2016.02.027

34.

Walker

L. S.

Garber

Greene

J. W.

(1991). Somatization symptoms in pediatric abdominal pain patients: Relation to chronicity of abdominal pain and parent somatization. Journal of Abnormal Child Psychology, 19(4), 379–394. https://doi.org/10.1007/BF00919084

35.

Walker

L. S.

Garber

Greene

J. W.

(1993). Psychosocial correlates of recurrent childhood pain: A comparison of pediatric patients with recurrent abdominal pain, organic illness, and psychiatric disorders. Journal of Abnormal Psychology, 102(2), 248–258. https://doi.org/10.1037/0021-843X.102.2.248

36.

Walker

L. S.

Garber

Greene

J. W.

(1994). Somatic complaints in pediatric patients: A prospective study of the role of negative life events, child social and academic competence, and parental somatic symptoms. Journal of Consulting and Clinical Psychology, 62(6), 1213–1221. https://doi.org/10.1037/0022-006X.62.6.1213

37.

Walker

L. S.

Greene

J. W.

(1991). The Functional Disability Inventory: Measuring a neglected dimension of child health status. Journal of Pediatric Psychology, 16(1), 39–58. https://doi.org/10.1093/jpepsy/16.1.39

38.

Walkup

(2009). Practice parameter on the use of psychotropic medication in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 48(9), 961–973. https://doi.org/10.1097/CHI.0b013e3181ae0a08

39.

Welch

L. C.

Litman

H. J.

Borba

C. P.

Vincenzi

Henderson

D. C.

(2015). Does a physician’s attitude toward a patient with mental illness affect clinical management of diabetes? Results from a mixed-method study. Health Services Research, 50(4), 998–1020.