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Chapter 18 - Bodily Distress Disorder and Dissociative Disorders

Published online by Cambridge University Press:  10 October 2025

Shermin Imran
Affiliation:
Greater Manchester NHS Foundation Trust
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Summary

Bodily Distress Disorder and Dissociative Disorders are disorders frequently encountered across paediatric specialties. These disorders place high psychosocial, educational and financial strains on children and their families as well as a substantial burden on the health care system with a potential risk for iatrogenic harm to the child due to unnecessary diagnostic evaluations and fruitless treatment attempts leading to increased costs. Predisposing factors include neurodevelopmental disorders and often co-morbidities such as anxiety and depression exist. The current best evidence-based treatment is psychological interventions that involve active participation from both the child and the parents. As early diagnostics and relevant intervention may improve prognosis and potentially decrease the risk of continued persistent and disabling somatic and co-occurring psychiatric symptoms later in life, it is important to address these disorders in young people. Due to the particular characteristics of somatic complaints combined with a high risk of psychiatric co-morbidities and specialised psychological interventions as best evidence-based practice, the diagnostics and treatment should optimally take place in close collaboration between the paediatric/medical setting and child and adolescent psychiatry.

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Publisher: Cambridge University Press
Print publication year: 2025

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References

Roenneberg, C, Sattel, H, Schaefert, R, Henningsen, P, Hausteiner-Wiehle, C. Functional Somatic Symptoms. Dtsch Arztebl Int. 2019 Jun;116(33–34):553–60.Google ScholarPubMed
Löwe, B, Toussaint, A, Rosmalen, JGM, et al. Persistent Physical Symptoms: Definition, Genesis, and Management. Lancet. 2024;403(10444):2649–62.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. 2013. https://doi.org/10.1176/appi.books.9780890425596.CrossRefGoogle Scholar
World Health Organisation. International Statistical Classification of Diseases and Related Health Problems: ICD-11. 11th ed. World Health Organisation, 2019.Google Scholar
Rask, CU, Olsen, EM, Elberling, H, et al. Functional Somatic Symptoms and Associated Impairment in 5–7-Year-Old Children: The Copenhagen Child Cohort 2000. Eur J Epidemiol. 2009;24(10):625–34.CrossRefGoogle ScholarPubMed
Kallesoe, KH, Rimvall, MK, Schroder, A, Jensen, JS, Wicksell, RK, Rask, CU. Adolescents with Functional Somatic Syndromes: Symptom Profiles, Illness Perception, Illness Worry and Attachment Orientation. J Psychosom Res. 2021;145:110430.CrossRefGoogle ScholarPubMed
Campo, JV. Annual Research Review: Functional Somatic Symptoms and Associated Anxiety and Depression – Developmental Psychopathology in Pediatric Practice. J Child Psychol Psychiatry. 2012;53(5):575–92.CrossRefGoogle ScholarPubMed
McWilliams, A, Reilly, C, Gupta, J, Hadji-Michael, M, Srinivasan, R, Heyman, I. Autism Spectrum Disorder in Children and Young People with Non-epileptic Seizures. Seizure. 2019;73:5155.CrossRefGoogle Scholar
Lipsker, CW, Bölte, S, Hirvikoski, T, Lekander, M, Holmström, L, Wicksell, RK. Prevalence of Autism Traits and Attention-Deficit Hyperactivity Disorder Symptoms in a Clinical Sample of Children and Adolescents with Chronic pain. J Pain Res. 2018;11:2827–36.Google Scholar
Janssens, KA, Klis, S, Kingma, EM, Oldehinkel, AJ, Rosmalen, JG. Predictors for Persistence of Functional Somatic Symptoms in Adolescents. J Pediatr. 2014;164(4):900–905 e2.CrossRefGoogle ScholarPubMed
Kozlowska, K. The Developmental Origins of Conversion Disorders. Clin Child Psychol Psychiatry. 2007;12(4):487510.CrossRefGoogle ScholarPubMed
World Health Organisation. International Statistical Classification of Diseases and Related Health Problems. ICD-11. Dissociative Disorders. 11th ed. World Health Organisation, 2019.Google Scholar
Hansen, AS, Rask, CU, Christensen, A-E, Rodrigo-Domingo, M, Christensen, J, Nielsen, RE. Psychiatric Disorders in Children and Adolescents with Psychogenic Nonepileptic Seizures. Neurology. 2021;97(5):e464–75.CrossRefGoogle ScholarPubMed
Hansen, ASR, Rask, CU, Domingo, MR, Pristed, SG, Christensen, J, Nielsen, RE. Incidence Rates and Characteristics of Pediatric Onset Psychogenic Nonepileptic Seizures. Pediatr Res. 2020;88(5):796803. https://doi.org/10.1038/s41390-020-0945-z.CrossRefGoogle ScholarPubMed
Petersen, MW, Schröder, A, Jørgensen, T, et al. Irritable Bowel, Chronic Widespread Pain, Chronic Fatigue and Related Syndromes Are Prevalent and Highly Overlapping in the General Population: DanFunD. Sci Rep. 2020;10(1):3273.CrossRefGoogle ScholarPubMed
Ottová-Jordan, V, Smith, OR, Gobina, I, et al. Trends in Multiple Recurrent Health Complaints in 15-Year-Olds in 35 Countries in Europe, North America and Israel from 1994 to 2010. Eur J Public Health. 2015;25 Suppl 2:2427.CrossRefGoogle ScholarPubMed
Thomsen, RW, Öztürk, B, Pedersen, L, et al. Hospital Records of Pain, Fatigue, or Circulatory Symptoms in Girls Exposed to Human Papillomavirus Vaccination: Cohort, Self-controlled Case Series, and Population Time Trend Studies. Am J Epidemiol. 2020;189(4):277–85. https://doi.org/10.1093/aje/kwz284. PMID: 31899791; PMCID: PMC7274189.CrossRefGoogle ScholarPubMed
Rask, CU, Bonvanie, IJ, Garralda, ME. Risk and Protective Factors and Course of Functional Somatic Symptoms in Young People. In Hodes, M, Gau, S, Petrus De Vries, SG (eds), Understanding Uniqueness and Diversity in Child and Adolescent Mental Health. 1st ed. Academic Press, 2018, 77113.CrossRefGoogle Scholar
Vesterling, C, Schütz-Wilke, J, Bäker, N, et al. Epidemiology of Somatoform Symptoms and Disorders in Childhood and Adolescence: A Systematic Review and Meta-Analysis. Health & Social Care in the Community. 2023. https://doi.org/10.1155/2023/6242678.CrossRefGoogle Scholar
Romero-Acosta, K, Canals, J, Hernández-Martínez, C, Penelo, E, Zolog, TC, Domènech-Llaberia, E. Age and Gender Differences of Somatic Symptoms in Children and Adolescents*. J Ment Health. 2013;22(1):3341. https://doi.org/10.3109/09638237.2012.734655.CrossRefGoogle ScholarPubMed
Horst, S, Shelby, G, Anderson, J, et al. Predicting Persistence of Functional Abdominal Pain from Childhood into Young Adulthood. Clin Gastroenterol Hepatol. 2014;12(12):2026–32.CrossRefGoogle ScholarPubMed
Saunders, NR, Gandhi, S, Chen, S, et al. Health Care Use and Costs of Children, Adolescents, and Young Adults with Somatic Symptom and Related Disorders. JAMA Network Open. 2020;3(7):e2011295-e.CrossRefGoogle Scholar
Operto, FF, Coppola, G, Mazza, R, et al. Psychogenic Nonepileptic Seizures in Pediatric Population: A Review. Brain Behav. 2019;9(12):e01406.CrossRefGoogle ScholarPubMed
Lieb, R, Pfister, H, Mastaler, M, Wittchen, HU. Somatoform Syndromes and Disorders in a Representative Population Sample of Adolescents and Young Adults: Prevalence, Comorbidity and Impairments. Acta Psychiatr Scand. 2000;101(3):194208.CrossRefGoogle Scholar
Jans, T, Schneck-Seif, S, Weigand, T, et al. Long-Term Outcome and Prognosis of Dissociative Disorder with Onset in Childhood or Adolescence. Child Adolesc Psychiatry Ment Health. 2008;2(1):19.CrossRefGoogle ScholarPubMed
Kline, CL, Shamshair, S, Kullgren, KA, Leber, SM, Malas, N. A Review of the Impact of Sociodemographic Factors on the Assessment and Management of Pediatric Somatic Symptom and Related Disorders. J Acad Consult Liaison Psychiatry. 2023;64(1):5864.CrossRefGoogle ScholarPubMed
Salmon, M, Sibeoni, J, Harf, A, Moro, MR, Ludot-Grégoire, M. Systematic Review on Somatization in a Transcultural Context Among Teenagers and Young Adults: Focus on the Nosography Blur. Front Psychiatry. 2022;13:897002.CrossRefGoogle Scholar
Korterink, JJ, Diederen, K, Benninga, MA, Tabbers, MM. Epidemiology of Pediatric Functional Abdominal Pain Disorders: A Meta-analysis. PloS One. 2015;10(5):e0126982.CrossRefGoogle ScholarPubMed
Tanaka, H, Terashima, S, Borres, MP, Thulesius, O. Psychosomatic Problems and Countermeasures in Japanese Children and Adolescents. Biopsychosoc Med. 2012;6:6.CrossRefGoogle ScholarPubMed
de Gusmão, CM, Guerriero, RM, Bernson-Leung, ME, et al. Functional Neurological Symptom Disorders in a Pediatric Emergency Room: Diagnostic Accuracy, Features, and Outcome. Pediatr Neurol. 2014;51(2):233–38.CrossRefGoogle Scholar
Walker, LS. Commentary: Understanding Somatic Symptoms: From Dualism to Systems, Diagnosis to Dimensions, Clinical Judgement to Clinical Science. J Pediatr Psychol. 2019;44(7):862–67.CrossRefGoogle ScholarPubMed
Henningsen, P, Gundel, H, Kop, WJ, et al. Persistent Physical Symptoms as Perceptual Dysregulation: A Neuropsychobehavioral Model and Its Clinical Implications. Psychosom Med. 2018;80(5):422–31.CrossRefGoogle ScholarPubMed
Kube, T, Rozenkrantz, L, Rief, W, Barsky, A. Understanding Persistent Physical Symptoms: Conceptual Integration of Psychological Expectation Models and Predictive Processing Accounts. Clin Psychol Rev. 2020;76:101829.CrossRefGoogle ScholarPubMed
Rask, CU, Ornbol, E, Olsen, EM, Fink, P, Skovgaard, AM. Infant Behaviors Are Predictive of Functional Somatic Symptoms at Ages 5–7 Years: Results from the Copenhagen Child Cohort CCC2000. J Pediatr. 2013;162(2):335–42.CrossRefGoogle ScholarPubMed
Buchnik-Daniely, Y, Vannikov-Lugassi, M, Shalev, H, Soffer-Dudek, N. The Path to Dissociative Experiences: A Direct Comparison of Different Etiological Models. Clin Psychol Psychother. 2021;28(5):1091–102.CrossRefGoogle ScholarPubMed
Ibeziako, P, Choi, C, Randall, E, Bujoreanu, S. Bullying Victimization in Medically Hospitalized Patients with Somatic Symptom and Related Disorders: Prevalence and Associated Factors. Hosp Pediatr. 2016;6(5):290–96.CrossRefGoogle ScholarPubMed
Bonvanie, IJ, van Gils, A, Janssens, KA, Rosmalen, JG. Sexual Abuse Predicts Functional Somatic Symptoms: An Adolescent Population Study. Child Abuse Negl. 2015;46:17.CrossRefGoogle ScholarPubMed
Brookes, M, Sharpe, L, Kozlowska, K. Attentional and Interpretational Biases Toward Pain-Related Stimuli in Children and Adolescents: A Systematic Review of the Evidence. J Pain. 2018;19(10):1091–101.CrossRefGoogle ScholarPubMed
Hulgaard, DR, Rask, CU, Risør, MB, Dehlholm, G. ‘I Can Hardly Breathe’: Exploring the Parental Experience of Having a Child with a Functional Disorder. J Child Health Care. 2019:1367493519864745.CrossRefGoogle Scholar
Gao, X, McSwiney, P, Court, A, Wiggins, A, Sawyer, SM. Somatic Symptom Disorders in Adolescent Inpatients. J Adolesc Health. 2018;63(6):779–84.CrossRefGoogle ScholarPubMed
Ingeman, K, Hulgaard, DR, Rask, CU. Health Anxiety by Proxy – Through the Eyes of the Parents. J Child Health Care. 2024;28(1):2236.CrossRefGoogle ScholarPubMed
Cottrell, DJ. Fifteen-Minute Consultation: Medically Unexplained Symptoms. Arch Dis Child Educ Pract Ed. 2016;101(3):114–18.CrossRefGoogle ScholarPubMed
Ibeziako, P, Brahmbhatt, K, Chapman, A, et al. Developing a Clinical Pathway for Somatic Symptom and Related Disorders in Pediatric Hospital Settings. Hosp Pediatr. 2019;9(3):147–55.CrossRefGoogle ScholarPubMed
Kozlowska, K. Functional Somatic Symptoms in Childhood and Adolescence. Curr Opin Psychiatry. 2013;26(5):485–92.CrossRefGoogle ScholarPubMed
Bonvanie, IJ, Kallesoe, KH, Janssens, KAM, Schroder, A, Rosmalen, JGM, Rask, CU. Psychological Interventions for Children with Functional Somatic Symptoms: A Systematic Review and Meta-Analysis. J Pediatr. 2017;187:272–81 e17.CrossRefGoogle ScholarPubMed
Baber, K, Rodriguez, KAON. Cognitive Behavioral Therapy for Functional Abdominal Pain Disorders. In Friedberg, RD, Paternostro, JK (eds), Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions. Cham: Springer International Publishing, 2019, 201–17.Google Scholar
Hulgaard, D, Dehlholm-Lambertsen, G, Rask, CU. Family-Based Interventions for Children and Adolescents with Functional Somatic Symptoms: A Systematic Review. J Fam Ther. 2019;41(1):428.CrossRefGoogle Scholar
Edwards, TM, Wiersma, M, Cisneros, A, Huth, A. Children and Adolescents with Medically Unexplained Symptoms: A Systematic Review of the Literature. Am J Fam Ther. 2019;47(3):183–97.CrossRefGoogle Scholar
American Academy of Pediatrics. Mind-Body Therapies in Children and Youth. Pediatrics. 2016;138(3):e20161896. https://doi.org/10.1542/peds.2016-1896.CrossRefGoogle Scholar
Rutten, J, Vlieger, AM, Frankenhuis, C, et al. Home-Based Hypnotherapy Self-exercises vs Individual Hypnotherapy With a Therapist for Treatment of Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, or Functional Abdominal Pain Syndrome: A Randomized Clinical Trial. JAMA Pediatr. 2017;171(5):470–77.CrossRefGoogle ScholarPubMed
Frostholm, L, Rask, CU. Third Wave Treatments for Functional Somatic Syndromes and Health Anxiety Across the Age Span: A Narrative Review. CPE. 2019;1(1):133. https://doi.org/10.32872/cpe.v1i1.32217.CrossRefGoogle Scholar
Martin, AE, Newlove-Delgado, TV, Abbott, RA, et al. Pharmacological Interventions for Recurrent Abdominal Pain in Childhood. Cochrane Database Syst Rev. 2017;3(3):CD010973.Google ScholarPubMed
Heimann, P, Herpertz-Dahlmann, B, Buning, J, et al. Somatic Symptom and Related Disorders in Children and Adolescents: Evaluation of a Naturalistic Inpatient Multidisciplinary Treatment. Child Adolesc Psychiatry Ment Health. 2018;12(34). eCollection 2018. https://doi.org/10.1186/s13034-018-0239-y.Google ScholarPubMed
Hulgaard, DR, Rask, CU, Risor, MB, Dehlholm, G. Illness Perceptions of Youths with Functional Disorders and Their Parents: An Interpretative Phenomenological Analysis Study. Clin Child Psychol Psychiatry. 2020;25(1):4561.CrossRefGoogle ScholarPubMed

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