Developing a Clinical Pathway for Somatic Symptom and Related Disorders in Pediatric Hospital Settings

Author:

Ibeziako Patricia1,Brahmbhatt Khyati23,Chapman Andrea4,De Souza Claire5,Giles Lisa6,Gooden Shanti3,Latif Finza7,Malas Nasuh8,Namerow Lisa9,Russell Ruth10,Steinbuchel Petra3,Pao Maryland11,Plioplys Sigita12

Affiliation:

1. Department of Psychiatry, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts;

2. Langley Porter Psychiatric Institute,

3. Department of Psychiatry, Weill Institute for Neurosciences, and Benioff Children’s Hospital, University of California, San Francisco, San Francisco, California;

4. Department of Psychiatry, British Columbia Children’s Hospital and The University of British Columbia, Vancouver, Canada;

5. Department of Psychiatry, The Hospital for Sick Children and University of Toronto, Toronto, Canada;

6. Department of Psychiatry and Behavioral Health, Primary Children’s Hospital and School of Medicine, The University of Utah, Salt Lake City, Utah;

7. Department of Psychiatry and Behavioral Sciences, Children’s National Medical Center and The George Washington University, Washington, District of Columbia;

8. Division of Child and Adolescent Psychiatry, Department of Psychiatry, C.S. Mott Children’s Hospital, University of Michigan Hospital Systems, Ann Arbor, Michigan;

9. Department of Psychiatry, Connecticut Children’s Medical Center and Institute of Living, School of Medicine, University of Connecticut, Hartford, Connecticut;

10. Department of Psychiatry, Montreal Children’s Hospital and McGill University, Montreal, Canada;

11. Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland; and

12. Department of Child and Adolescent Psychiatry, Ann and Robert H. Lurie Children’s Hospital of Chicago and Feinberg School of Medicine, Northwestern University, Chicago, Illinois

Abstract

Somatic symptom and related disorders (SSRDs) are commonly encountered in pediatric hospital settings. There is, however, a lack of standardization of care across institutions for youth with these disorders. These patients are diagnostically and psychosocially complex, posing significant challenges for medical and behavioral health care providers. SSRDs are associated with significant health care use, cost to families and hospitals, and risk for iatrogenic interventions and missed diagnoses. With sponsorship from the American Academy of Child and Adolescent Psychiatry and input from multidisciplinary stakeholders, we describe the first attempt to develop a clinical pathway and standardize the care of patients with SSRDs in pediatric hospital settings by a working group of pediatric consultation-liaison psychiatrists from multiple institutions across North America. The authors of the SSRD clinical pathway outline 5 key steps from admission to discharge and include practical, evidence-informed approaches to the assessment and management of children and adolescents who are medically hospitalized with SSRDs.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health

Reference36 articles.

1. American Academy of Child and Adolescent Psychiatry. Physical symptoms of emotional distress: somatic symptom and related disorders. 2018. Available at: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Physical_Symptoms_of_Emotional_Distress-Somatic_Symptoms_and_Related_Disorders.aspx. Accessed August 27, 2018

2. Diagnostic and Statistical Manual of Mental Disorders

3. Characteristics of medically hospitalized pediatric patients with somatoform diagnoses;Bujoreanu;Hosp Pediatr,2014

4. Somatoform disorders and trauma in medically-admitted children, adolescents, and young adults: prevalence rates and psychosocial characteristics;Thomson;Psychosomatics,2014

5. Perceived stigma in functional somatic syndromes and comparable medical conditions;Looper;J Psychosom Res,2004

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