'It is not in our heads'. the management and psychiatric referral of children with somatically-unexplained abdominal pain
Van der Hoeven, J.; Buitelaar, J.K.
Nederlands Tijdschrift Voor Geneeskunde 147(26): 1249-1252
2003
ISSN/ISBN: 0028-2162 PMID: 12861662 Document Number: 564321
Two patients, girls aged 9 and 10 years, were admitted to the paediatric ward due to somatically-unexplained debilitating abdominal pain. Both they and their parents expressed resistance to psychiatric examination before and after admission. After conversations with a psychiatrist and an activation programme, one of the girls recovered and the other family broke the medical contact after having enforced a lot of somatic investigations; when followed up, they stated that the complaints had disappeared. The management of somatically-unexplained abdominal pain in children is not always easy. It is essential to introduce the psychiatrist as an expert in treating the consequences of the complaints rather than an expert in searching for psychiatric causes. Associated impaired functioning is a sign of severe symptoms, which require referral to a psychiatrist or a psychologist.