Clinical profile of somatic symptom and related disorders in children


  • . Richa Department of Pediatrics, TNMC and BYL Nair Hospital, Mumbai, Maharashtra, India
  • Radha G. Ghildiyal Department of Pediatrics, LTTMC and Sion Hospital, Mumbai, Maharashtra, India
  • Alka Subramanyam Department of Psychiatry, TNMC and BYL Nair Hospital, Mumbai, Maharashtra, India
  • Pragya Sharma Department of Psychiatry, KB Bhabha Hospital, Mumbai, Maharashtra, India



DSM 5, Somatic symptoms, Stressors


Background: Somatic symptom disorder is characterized by somatic symptoms that are either very distressing or result in significant disruption of functioning, as well as excessive and disproportionate thoughts, feeling and behavior regarding those symptoms. The objective of this study was to study the clinical profile of patients presenting with somatic symptom and related disorders and to attempt to identify the stressors in these children.

Methods: An open labelled, unidirectional and prospective study was conducted at a tertiary care hospital on 60 children in 5 to 16-year age group over a period of 18 months.

Results: The overall prevalence of somatic symptom and related disorders was 60 (0.2%). In the present study, 35 (58.3%) were males and 25 (41.7%) were females. 50% patients belonged to the >8 years and ≤12-year age group. 51.7% had average IQ. 31 (51.7%) patients belonged to lower middle class. Out of the total 60 patients, 46 (76.7%) belonged to a nuclear family. Parents with a post graduate degree had less number of children (3.3%) presenting with somatic symptoms. The most common presenting symptom reported was generalized pain by 30 (50.0%) among somatic symptoms and Pseudo seizures (33.3%) among conversion symptoms. Family issues (most common stressor) was found in 38 (63.3%) subjects. 30 (50.0%) patients had authoritarian parents. 46.7% of those counselled did not require any further intervention. As per the life events scale, the mean was 4.43.

Conclusions: In the present study, the most important areas in which stress was apparent was in school and family. Our study highlights the need for a joint effort by parents, pediatricians, psychiatrists and teachers to help our children cope with the stress of today’s fast paced competitive world.


Pallant A, Elizabeth T. Uncovering unexplained origins of physical complaints. Contemporary Pediatr. 2012;29(2):30-1.

Jayprakash R. Clinical profile of children and adolescents attending the behavioural Pediatrics unit OPD in a tertiary care set up. J Indian Association Child Adolescent Mental Health. 2012;8(3):51-66.

De la Fuente JM, Bobes J, Vizuete C, Teresa M, Morlan I, Mendlewicz J. Neurologic Soft signs in borderline personality disorder. J Clin Psych. 2006;67(4):541-6.

Bisht J, Sankhyan N, Kaushal RK, Sharma RC, Grover N. Clinical profile of pediatric somatoform disorders. Indian Pediatr. 2008;45:111-5.

Gupta V, Singh A, Upadhyay S, Bhatia B. Clinical profile of somatoform disorders in children. Indian J Pediatr. 2011;78:283-6.

Trivedi JK, Singh H, Sinha PK. A clinical study of hysteria in children and adolescents. Indian J Psychiatry. 1982;24(1):70-4.

Marwah A, Swami KM, Kumar M. Childhood somatoform disorders and its associated stressors. Pediatric Oncall. 2016;13:42.

Malhi P, Singhi P. Clinical characteristics and outcome of children and adolescents with conversion disorder. Indian Pediatr. 2002;39:747-52.

Head H. An address on the diagnosis of hysteria. Br Med J. 1922;1:827-9.

Malhotra S, Singh G, Mohan A. Somatoform and dissociative disorders in children and adolescents: a comparative study. Indian J Psych. 2005;47:39-43.

Sousa DA, Sousa DD. Childhood neurosis: child psychiatry. Bhalani Book Depot. 1987:254-60.

Stelnhouse HC, Aster MW, Pfeiffer E, Godel D. Comparative study of conversion disorders in childhood and adolescence. J Child Psychol Psych. 1989;30:615-21.

Walker LS, Green JW. Negative life events and symptoms resolution in Pediatric abdominal pain patients. J Pediatr Psychol. 1991;16:341-60.

Alexander KL, Entwisle DR, Bedinger SD. When expectations work: race and socioeconomic differences in school performance. Social Psychology Quarterly. 1994;57(4):283-99.

Smith P, Fairley M, Procopis P. Clinical features of conversion disorder. Arch Dis Child. 1988;63:408-14.

Ghosh JK, Majumder P, Pant P, Dutta R, Bhatia BD. Clinical profile and outcome of conversion disorder in a tertiary care hospital of India. J Trop Pediatr. 2007;53:213-4.

Deka K, Chaudhary PK, Bora K, Kalita P. A study of clinical correlates and sociodemographic profile in conversion disorder. Indian J Psych. 2007;49:205-7.

Maloney M. Diagnosing hysterical conversion reaction in children. J Pediatr. 1980;97:1016-20.

Rachel S, Constance W, Beth G. Somatic symptoms during adolescence: does parenting style play a role? mental health. J Adolescent Health. 2014;161:S83-4.

Malhotra S, Kohli A, Kapoor M, Pradhan B. Incidence of childhood psychiatric disorders in India. Indian J Psych. 2009;51(2):101-7.






Original Research Articles