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Special Issue "Assessment and Treatment of Children and Adolescents with Functional Somatic Disorders"

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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Child and Adolescent Psychiatry".

Deadline for manuscript submissions: 5 March 2024 | Viewed by 2506

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Special Issue Editor

Prof. Dr. Charlotte Ulrikka Rask

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Department of Child and Adolescent Psychiatry, Aarhus University Hospital, 8200 Aarhus, Denmark
Interests: functional somatic disorders; health anxiety; pediatric liaison psychiatry; child psychiatric epidemiology; concurrent somatic and psychiatric health problems in children/adolescents; internetbased psychological treatment; illness perceptions; illness behaviours; developmental trajectories of psychopathology
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Dear Colleagues,

Functional somatic disorders are commonly encountered in paediatric medicine. These disorders are characterised by the presentation of somatic symptoms or illness worries that are disproportionate to the history, physical examinations, laboratory tests, and other investigative findings. The diagnostic process is often delayed with a risk of excessive and potentially harmful medical investigations. In addition, there is high psychiatric comorbidity, especially with anxiety and depression.

Without proper treatment, functional somatic disorders place significant psychosocial, educational, and financial strains on children and their families, as well as a substantial burden on the healthcare system with high healthcare costs. In particular, psychological therapies have proven to be effective, but the effects are mostly small to moderate. Thus, there is an urgent need for the improvement of models for systematic assessment, diagnostic tools, and the development of specialised treatment across the spectrum of severity. This Special Issue offers a unique opportunity to contribute to a state-of-the-art series on functional somatic disorders in children and adolescents with special emphasis on studies presenting original research on assessment issues and/or new treatment programmes in this area.

Prof. Dr. Charlotte Ulrikka Rask
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

functional somatic disorders
functional neurological disorder
somatic and symptom related disorders
bodily distress disorder
functional somatic syndromes
assessment
diagnostics
psychotherapy
psychoeducation
treatments

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Research

34 pages, 2962 KiB

Open AccessArticle

Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder

and

Children 2023, 10(11), 1724; https://doi.org/10.3390/children10111724 - 24 Oct 2023

Viewed by 782

Abstract

Previous studies suggest that subjective distress in children with functional neurological disorder (FND) is associated with stress-system dysregulation and modulates aberrant changes in neural networks. The current study documents illness-promoting psychological processes in 76 children with FND (60 girls and 16 boys, aged 10.00−17.08 years) admitted to the Mind–Body Program. The children completed a comprehensive family assessment and self-report measures, and they worked with the clinical team to identify psychological processes during their inpatient admission. A total of 47 healthy controls (35 girls and 12 boys, aged 8.58–17.92 years) also completed self-report measures, but were not assessed for illness-promoting psychological processes. Children with FND (vs. controls) reported higher levels of subjective distress (total DASS score, t(104.24) = 12.18; p ˂ 0.001) and more adverse childhood experiences across their lifespans (total ELSQ score, t(88.57) = 9.38; p ˂ 0.001). Illness-promoting psychological processes were identified in all children with FND. Most common were the following: chronic worries about schoolwork, friendships, or parental wellbeing (n = 64; 84.2%); attention to symptoms (n = 61; 80.3%); feeling sad (n = 58; 76.3%); experiencing a low sense of control (helplessness) in relation to symptoms (n = 44; 57.9%); pushing difficult thoughts out of mind (n = 44; 57.9%); self-critical rumination (n = 42; 55.3%); negative/catastrophic-symptom expectations (n = 40; 52.6%); avoidance of activities (n = 38; 50%); intrusive thoughts/feelings/memories associated with adverse events (n = 38, 50%); and pushing difficult feelings out of mind (n = 37; 48.7%). In children with FND—disabled enough to be admitted for inpatient treatment—illness-promoting psychological processes are part of the clinical presentation. They contribute to the child’s ongoing sense of subjective distress, and if not addressed can maintain the illness process. A range of clinical interventions used to address illness-promoting psychological processes are discussed, along with illustrative vignettes. Full article

(This article belongs to the Special Issue Assessment and Treatment of Children and Adolescents with Functional Somatic Disorders)

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10 pages, 1086 KiB

Open AccessArticle

Treatment Provided in Children and Adolescents with Functional Seizures—A Danish Nationwide Cohort

Nana Brandborg Sørensen

René Ernst Nielsen

Ann-Eva Christensen

Mikkel Kristian Kjeldsen

Charlotte Ulrikka Rask

Jakob Christensen

and

Anne Sofie Hansen

Children 2023, 10(7), 1218; https://doi.org/10.3390/children10071218 - 14 Jul 2023

Viewed by 567

Abstract

Background: Functional seizures (FS) are episodes of paroxysmal involuntary movements and altered consciousness without the typical changes in the electroencephalography as with epilepsy. A multidisciplinary approach is the golden standard in the treatment of FS. This study examined the cross-sectoral collaboration and treatment modalities provided to children and adolescents after a diagnosis of FS. Method: A Danish nationwide cohort, consisting of 334 children and adolescents, aged 5–17 years, with a validated diagnosis of FS during the period 2004–2014 was studied. Medical record data were collected from diagnosing hospital departments. Management and treatment modalities from the time of diagnosis up to three months after diagnosis were explored. Results: The most used treatment modalities were psychoeducation (n = 289, 86.5%) and follow-up in outpatient care (n = 192, 70.6%). A cross-sectoral collaboration was initiated for a third of cases (n = 98, 29.3%). The most commonly provided treatment combination consisted of psychoeducation, follow-up in outpatient care and psychotherapy; however, only a few patients received this specific combination (n = 14, 4.2%). Conclusions: The treatment applied was individualized and consisted of varying use of treatment modalities. Initiatives to curate clinical guidelines and implement a multidisciplinary treatment approach should be further explored to improve treatment for this young group of patients. Full article

(This article belongs to the Special Issue Assessment and Treatment of Children and Adolescents with Functional Somatic Disorders)

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14 pages, 1574 KiB

Open AccessArticle

Clinical Impact of Systematic Assessment and Psychoeducation in Specialized Treatment of Adolescents with Severe Functional Somatic Disorders: Results from the AHEAD Study

Karen Hansen Kallesøe

Kaare Bro Wellnitz

Eva Ørnbøl

and

Charlotte Ulrikka Rask

Children 2023, 10(7), 1101; https://doi.org/10.3390/children10071101 - 22 Jun 2023

Viewed by 669

Abstract

Functional somatic disorders (FSD), characterized by persistent and disabling physical symptoms, are common in adolescents. Diagnostic uncertainty and insufficient illness explanations are proposed perpetuating factors that may constitute barriers for treatment engagement. This study describes the impact of manualized assessment and psychoeducation on diagnostic certainty and various clinical outcomes in adolescents with multi-system FSD. Ninety-one adolescents (15–19 years) received systematic assessment (4 h) and a subsequent psychiatric consultation (1.5 h). Clinical characteristics included self-reported physical health, symptom severity, illness perception, illness-related behavior, and psychological flexibility assessed before and approximately two months after assessment, prior to specialized treatment. Data were analyzed using t-tests. Immediately following assessment, 71 (80.7%) adolescents out of 88 reported a higher diagnostic certainty and 74 (84.1%) reported that attending assessment gave them positive expectations for future treatment. A clinically relevant improvement of physical health was not observed at two months but considerable reductions were seen in symptom severity, illness worry, negative illness perceptions, illness-related limiting behavior, and psychological inflexibility. The results emphasize that systematic assessment and psychoeducation are important in their own right in the specialized treatment of adolescents with severe FSD. Full article

(This article belongs to the Special Issue Assessment and Treatment of Children and Adolescents with Functional Somatic Disorders)

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Special Issue "Assessment and Treatment of Children and Adolescents with Functional Somatic Disorders"

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