ABSTRACT
Children and adolescents may be referred for psychological consultation with the central focus being a somatic complaint. Somatization or conversion symptoms, chronic fatigue syndrome, pain, adjustment to chronic illness and preparation for anxiety-provoking medical and dental procedures are among the more common reasons for referral. This chapter addresses common childhood problems in each of these areas. Other conditions where somatic factors are involved, such as enuresis and encopresis, sensory impairment, head injury, eating disorders, drug abuse and injuries arising from physical abuse are discussed in other chapters. The anticipatory grieving process associated with life-threatening illness such as cancer is discussed in Chapter 24. However, before addressing specific somatic presentations, a consideration of the development of children’s concepts of illness and pain will be given, and some frameworks within which to conceptualize somatic problems will be presented. From a clinical perspective, the assessment and management of somatization problems and the management of chronic childhood illness must take account of children, conceptions of illness and pain which evolve as children mature. The wider psychosocial context within which illness occurs must also be taken into account.
