Pediatric Somatic Symptom and Related Disorders: Parent Acceptance Influences Recovery

Abstract

To assess how clinicians discuss the diagnosis of somatic symptom and related disorders (SSRDs) in patients admitted to a children's hospital and explore the effect of parent and patient acceptance of the diagnosis on recovery. In this cross-sectional study, we reviewed the electronic medical records of pediatric admissions diagnosed with SSRD over 18months. All diagnostic discussions with patients and families were analysed to identify concepts used by clinicians within these discussions and the extent of parent and patient acceptance of the diagnosis. Recovery status up to 12months after diagnosis was also identified. Acceptance and recovery were categorized as "full," "partial," or "none." Ninety-five of 123 (77.2%) patients (median age 14.3years, range 7.3-18.3) had at least 1 diagnostic discussion recorded. Clinical explanations within the diagnostic discussion spanned a variety of concepts, with the most common being a description of somatization (62%). Full parent acceptance of the diagnosis of SSRD was more likely when discussions involved two parents (P=.002). Full acceptance of the diagnosis by at least 1 parent was associated with complete functional recovery in their children (OR 8.94, 95% CI 2.24, 35.9, P=.002). In contrast, there was no significant association between full acceptance by patients and their recovery. The influence of parent acceptance of the diagnosis of SSRD reinforces the importance of therapeutic engagement with families, as well as with children and adolescents.