Many children have psychosomatic disorders the occurrence and course of which is related to psychological factors. This disorder is getting more common these days as psychosocial environment surrounding children is changing in many ways. So to prevent this disorder doctors should have knowledge of its pathogenesis, characteristics and stress.
Psychosomatic disorder is a pathologic condition in which functional and organic impairments are observed in a close association with psychosocial factors.
Common childhood psychosomatic disorders are peptic ulcer, early onset vomiting, repetitive abdominal pain, irritated bowel syndrome, bronchial asthma, hyperventilation syndrome, orthostatic hypotension, diabetes, obesity, tension type headache, atopic dermatitis, chronic urticaria, boldness, thamuria, enuresis, blurred vision, deaf, mutism.
Children with developmental disorder, behavioral disorder or eating disorder are more likely to be affected by stress. As they have difficulty complaining this effect with verbal language, they express it through somatic symptoms.
Psychosomatic disorders can be seen in all clinical departments.
Pathogenesis
When stimuli are assessed by cerebral cortex as stressor the hypothalamus-pituitary gland-adrenal gland axis is activated. When stress reaction is appropriate, anti-stress system works properly so that immune, hormone and autonomic nervous systems work in balance to provide homeostasis. When the reaction is overwhelming those 3 systems lose balance to develop new somatic symptoms or change the course of ongoing disease. This association is called psychosomatic correlation.
As children have high psychosomatic correlation, they are more likely to develop psychosomatic diseases. Children can not manifest by language their thought and instinct. When children feels anxiety or anger they manifest their dissatisfaction directly otherwise repress themselves to accustom into environment which results in psychosomatic disease.
Different children respond to stressor differently. Their manifestation is affected by their family, school, local background. Their physical and mental characteristics determines whether their manifestation of psychosomatic diseases be somatic symptoms or psychiatric symptoms or behavioral problems. But all these symptoms are not independent but able to transfer from one form into another.
Psychosocial stress
The problems in family
Neglecting parents: neglect, distrust, dismiss, abuse or irresponsible care allow children to become aggressive and easily annoyed and to develop somatic symptoms associated with stress.
Dominant parents: Some parents pursue strictness, obedience and dominance neglecting children's hope, temper and ability, which allow children to become less independent, feeling worthless, less adaptable and less resistant to stress.
Overprotecting parents: Some parents worry too much about their children and overprotect them, which allow children to become dependent and less strenuous. These children are more likely to develop psychosomatic diseases in response to little stress.
Submissive parents: Some parents submit all the claims and requirements of their children, which allow their children to become self-indulgent, crying and aggressive.
Paradoxical parents: Some parents criticize their children when they behave right otherwise praise them when they behave wrong. These parents' education is not consistent, which allow children to become emotionally unstable and tensed and further develop antisocial behaviors.
School problems
School problems consist of bad relationship with peers or teachers; frustration in study and activities; and burdens in terms of mind, body and time.
Children in stressful environment manifest their dissatisfaction by using language, emotion or behaviors; or complain pains.
General characteristics of childhood psychosomatic diseases.
1) The younger the more likely to develop systemic symptoms.
2) Many cases involve both metal and behavioral problems.
3) Changing environment can easily change symptoms.
4) Correction of habits and transient psychosomatic reaction can eliminate many symptoms.
5) Each stages of development have its own symptoms.
Symptoms and characteristics according to developmental stages.
1) Infants
Systematic symptoms are dominant and affected mainly by temperament and perinatal factors. Mother-child relationship and life environment matters. Delayed development and vomiting are common symptoms.
2) Toddlers
Predromes include light but repetitive symptoms mainly gastrointestinal. Inappropriate contact or separation from mother matters. Anxiety and deficient play are typical risk factors of developmental problems.
3) Before adolescence
Symptoms are affected more by endocrine system and ANS symptoms get more common. Headache, ocular pain, endogenous visual impairment and dysmenorrhea are likely to occur.
4) Adolescence
Symptoms are dramatic and psychosis gets common. Developmental risk factors are unstable body and mind; and increased interests in other genders and body. Sensory impairments, hyperventilation and anorexia nervosa are likely to occur.
Prevention of childhood psychosomatic diseases.
Parents should look carefully into signals manifested by children and teach children how to show emotion and realize their will.
Parents should be close to children being aware of childhood psychology. Parents should teach children that it is possible to talk not only about success but also about failure, the different skills to show their emotion deep inside mind through language and various types of behaviors. Children should be helped to have stable emotion. Children should become confident and independent and the environment surrounding children should pursue this purpose.
The cause and course of childhood psychosomatic diseases are affected by environmental factors which children depend on, thereby changing environmental factors can help to cure psychosomatic diseases. The younger the patient is the more important it is to investigate nearest people's psychology and environment.
You should be careful to these points below.
1) You should admit their complaints.
2) You should listen fully to their talk, understand and support them.
3) Responses in hospital, school and family should be consistent with each other.
Psychosomatic medicine helps children manifest their emotional troubles through language, improve their response skills and resistance. Childhood psychological development is as important as physical development. Our medical staffs and parents should be well aware of childhood psychosomatic medicine and do their best to bring up children into psychologically and physically healthy ones.
