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8 year old child complaining of stomach pain, with no medical issue/problem
Q1: When the paediatric says it’s somatic what does it mean?
Dr.YK – Somatic symptoms are physical symptoms that occur within the body but originating from psychological and emotional causes.
Q2: Is there any medical evidence for the symptom?
Dr.YK – Somatic symptoms do not have any medical basis. Medically unfounded symptoms are called psycho somatic symptoms. Child doesn’t have verbal ability to express distressing emotions. Child is distressed about something else but is expressing that in a physical form or physical symptom.
Q3: Any specific group of children who get impacted by these symptoms?
Dr.YK – Children who generally are scared, children who have anxious temperament or children with anxiety exhibit somatic symptoms. Younger children 8 or 9, who are still not able to express their distressing emotion, in younger children emotional vocabulary wouldn’t have developed so they express through physical symptoms.
Q4: Do children who verbalize also face somatic symptoms?
Dr.YK – Yes, there are older children who exhibit somatic symptoms because they could have developed anxiety.
Q5: Do special children exhibit somatic symptoms?
Dr.YK – Yes, special children exhibit somatic symptoms but in special children we need to look at their development, speech, cognitive ability. In special children to call it somatic, extensive work is required.
Q6: Are there any other somatic symptoms including stomach pain?
Dr.YK – There are lot of somatic symptoms, children could be feeling, like nausea, vomiting, headache, stomach aches, leg pain, and numbness. These symptoms might not have any organic cause or medical explanations.
Q7: How do you identify these symptoms?
Dr.YK – In order to identify these symptoms, we need to look at where these symptoms are exhibited. We should look at the child’s environment, school, and day care or during the exam or before going to the exam. We should pay attention to the facial expression, when the child is complaining about the symptoms. Is the child angry or sad or crying and also we should help the child learn to respond to their emotions.
Q8: Do these symptoms subside?
Dr.YK – These symptoms subside in a lot of children, but there are children where somatic symptoms continue and take intense form.
Q9: Do severe symptoms come under disorder?
Dr.YK – Yes, it could be somatic symptom disorder, where the child is spending disproportionate time and energy in worrying about those symptoms and these symptoms are misinterpreted as major illness. There could be a mild medical issue, but children with somatic symptom disorder amplify it and their functioning goes down because of their worrying, rather than the symptoms. Any symptoms interfering with their functioning may be intense in the form of disorder.
Q10: What is the suggestion for parents?
Dr.YK - Simple reassurance from the parents will help symptoms to subside, but if the symptoms are not subsiding they require therapy. In cognitive behaviour therapy, the child is thought how to deal with fears from physical symptoms and how to neutralise the fearful thoughts. In severe cases medications are recommended.
Q11: How can parents manage anxiety children with somatic symptoms?
Dr.YK – Step 1: Child should learn to manage and tolerate the situation. They should go through the situation even if it is anxiety provoking.
Step 2: Parents shouldn’t encourage avoidant behaviours.
Step 3: Parents should be positive and realistic in reassuring the child.
Step 4: Don’t belittle the child’s behaviour.
Step 5: Don’t magnify the fears of the child.
Step 6: Don’t ask leading questions. (Ex: Do you have pain while playing or studying)
Step 7: Don’t translate your own anxiety onto the child, as children pick up on facial expressions or other non verbal anxious gestures of parents.
Step 8: If the child isn’t improving, requires professional help.
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