Abstract
Zusammenfassung. Die Validität, Reliabilität und der klinischen Nutzen der gegenwärtigen Störungskategorie der somatoformen Störungen nach dem DSM-IV-TR sind stark umstritten. Die DSM-V-Arbeitsgruppe schlägt daher eine Neustrukturierung und Umbenennung der bisherigen Störungskategorie in Somatic Symptom Disorders vor. In diesem Artikel wird analysiert, ob die Diagnosekriterien der bisherigen somatoformen Störungen nach DSM-IV-TR und die Complex Somatic Symptom Störung dazu geeignet sind, Kinder und Jugendliche zu identifizieren, die durch medizinisch unklare Symptome in ihrem Alltag und ihrer Lebensqualität beeinträchtigt sind. Besonders die Somatisierungsstörung nach DSM-IV-TR erweist sich für Kinder und Jugendliche als ungeeignet. Einschränkungen des DSM-Ansatzes in der Klassifikation von somatoformen Störungen im Kindes- und Jugendalter werden dargestellt. Studien zeigen, dass die Gesundheit der Eltern einen wesentlichen Einfluss auf die Entstehung und Aufrechterhaltung somatoformer Störungen im Kindes- und Jugendalter sowie die Inanspruchnahme des Gesundheitswesens hat. In der neueste Version der Kriterien der Complex Somatic Symptom Störung wird diese besondere Situation von Kindern/Jugendlichen beachtet; die Diagnose kann auch gestellt werden, wenn die Eltern des Kindes exzessive Gedanken, Gefühle oder Verhaltensweisen aufgrund der Symptome ihres Kindes zeigen.
Abstract.The validity, reliability and clinical utility of the current DSM-IV-TR criteria for somatoform disorders are highly debated. The DSM-V workgroup therefore recommends restructuring and renaming the category into Somatic Symptom Disorders. In this article the suitability of the current DSM-IV-TR criteria of somatoform disorders and the suitability of the criteria of the Complex Somatic Symptom Disorder for the classification of children and adolescents are analyzed. Especially the somatization disorder is inappropriate for children and adolescents. General limitations of the DSM approach to classifying child and adolescent psychopathology are delineated. Studies show that the mental and physical well being of parents have a strong impact on the development and maintenance of somatoform disorders in children/adolescents as well as the children’s/adolescents’ health care utilization. Therefore, these disorders cannot be discussed in children without considering the parents. The latest draft of the Complex Somatic Symptom Disorder considers this special situation of children/adolescents; the diagnosis can also be given when parents exhibit excessive thoughts, feelings and behaviors related to the child’s somatic symptoms.
Literatur
(1980). Diagnostic and statistical manual of mental disorders, (3rd ed.), Washington, DC: Author.
(2000). Diagnostic and statistical manual of mental disorders, (4th ed.), Washington, DC: Author.
(2011a). Draft January 14, 2011. Somatic symptom disorders, Retrieved March 17, 2011 from www.dsm5.org/ProposedRevisions/Pages/SomatoformDisorders.aspx,
(2011b). J 00 Complex somatic symptom disorder, Retrieved June 18, 2011 from www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=368,
(2003). Taxometrics and developmental psychopathology. Development and Psychopathology, 15, 501– 527
(2008). A developmental perspective on functional somatic symptoms. Journal of Pediatric Psychology, 33, 547– 562
(2001). Psychosomatic complaints in schoolchildren: A Nordic comparison. Scandinavian Journal of Public Health, 29, 44– 54
(2007). Clinical profile of pediatric somatoform disorders. Indian Pediatrics, 45, 111– 115
(2005). Dissociation, childhood interpersonal trauma, and family functioning in patients with somatization disorder. American Journal of Psychiatry, 162, 899– 905
(2007). Physical and emotional health of mothers of youth with functional abdominal pain. Archives of Pediatrics & Adolescent Medicine, 161, 131– 137
(1999). Somatization in pediatric primary care: Association with psychopathology, functional impairment, and use of services. Journal of American Academy of Child and Adolescent Psychiatry, 9, 1093– 1101
(2002). Intergenerational transmission of somatization behavior: A study of chronic somatizers and their children. Psychological Medicine, 32, 805– 816
(2002). Somatoform disorders in children and adolescents: A comparison with other internalizing disorders. Annals of Clinical Psychiatry, 14, 23– 31
(2009). Editorial. The proposed diagnosis of somatic symptom disorders in DSM-V to replace somatoform disorders in DSM-IV- a preliminary report. Journal of Psychsomatic Research, 66, 473– 476
(2004). Parental reports of somatic symptoms in preschool children: Prevalence and association in a Spanish sample. Journal of American Academy of Child and Adolescent Psychiatry, 43, 598– 604
(2009). Can a developmental perspective facilitate a paradigm shift towards a mixed categorical-dimensional classification system. Clinical Psychology: Science and Practice, 16, 41– 48
(2007). Medically unexplained symptoms in children and adolescents. Clinical Psychology Review, 27, 855– 871
(1996). Physical symptoms and illness attitudes in adolescent: An epidemiological study. Journal of Child Psychology and Psychiatry, 37, 519– 528
(2000). Häufigkeit und Komorbidität somatoformer Störungen bei Jugendlichen. Ergebnisse der Bremer Jugendstudie. Zeitschrift für Klinische Psychology und Psychotherapie, 29, 97– 108
(1997). Somatoform disorders in children and adolescents: A review of the past 10 years. Journal of American Academy of Child and Adolescent Psychiatry, 36, 1329– 1338
(1991). Somatization symptoms in a community sample of children and adolescents: Further validation of the Children’s Somatization Inventory. Psychological Assessment, 3, 588– 595
(1990). Recurrent abdominal pain in children: Psychiatric diagnoses and parental psychopathology. Journal of American Academy of Child and Adolescent Psychiatry, 29, 648– 656
(2007). Pain, disability, and symptoms among siblings of children with functional abdominal pain. Journal of Developmental Behavioral Pediatrics, 28, 45– 46
(2001). Children’s health care use: A prospective investigation of factors related to care-seeking. Medical Care, 39, 990– 1001
(1997). The book of names: DSM-IV in context. Development and Psychopathology, 9, 231– 249
(1994). Models of dysfunction in developmental psychopathology. Clinical Psychology: Science and Practice, 1, 35– 52
(2002). Recurrent abdominal pain and headache. Psychopathology, life events and family functioning. European Child and Adolescent Psychiatry, 11, 115– 122
(2007). Epidemiology of the association between somatoform disorders and anxiety and depressive disorders: An update. Psychosomatic Medicine, 69, 860– 863
(2000). Somatoform syndromes and disorders in a representative sample of adolescents and young adults: Prevalence, comorbidity and impairment. Acta Psychiatrica Scandinavica, 101, 194– 208
(2002). The natural course of DSM-IV somatoform disorders and syndromes among adolescents and young adults: A prospective-longitudinal community study. European Psychiatry, 17, 321– 331
(1995). Families who somatize. Development and Behavioral Pediatrics, 16, 42– 46
(2005). Relationships between family and parent characteristics and functional abilities in children with recurrent pain syndromes: An investigation of moderating effects on the pathway from pain to disability. Journal of Pediatric Psychology, 30, 698– 707
(2007). Intergenerational transmission of health beliefs in somatoform disorders. British Journal of Psychiatry, 191, 449– 450
(2005). Somatoform disorders: Time for a new approach in DSM-V. American Journal of Psychiatry, 162, 847– 855
(2003). Editorial: Somatoform disorders in DSM-V. Psychosomatics, 44, 449– 451
(2007). Somatoforme Störungen. Diagnostik, Konzepte und Therapie bei Körpersymptomen ohne Organbefund, (2. Aufl.), Wien: Springer.
(2006). Trajectories of symptoms and impairment for pediatric patients with functional abdominal pain: A 5-year longitudinal study. Journal of American Academy of Child and Adolescent Psychiatry, 45, 737– 744
(2008). Funktionelle und somatoforme Störungen im Kindes- und Jugendalter, Göttingen: Hogrefe..
(2002). Childhood antecedents of hypochondriasis. Psychosomatics, 43, 282– 289
(2009). Soziale Angst / soziale Unsicherheit.. Kindheit und Entwicklung, 18, 1– 5
(2007). The impact of recurrent abdominal pain: Predictors of outcome in a large population cohort.. Acta Paediatrica, 96, 697– 701
(2006). Early parental and child predictors of recurrent abdominal pain at school age: Results of a large population-based study. Journal of American Academy of Child and Adolescent Psychiatry, 45, 729– 736
(2004). Somatoform disorders- new approaches to classification, conceptualization, and treatment. Journal of Psychosomatic Research, 56, 387– 390.
(2011). Bringt DSM-V die Lösung bei Somatoformen Störungen?. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 59,
(1990). Life events and family history in children with recurrent abdominal pain.. Journal of Psychosomatic Research, 34, 171– 181
(2000). Developmental psychopathology: Concepts and challenges. Development and Psychopathology, 12, 265– 296
(2005). Maternal self-assessed health and emotionality predict maternal response to child illness. Children’s Health Care, 34, 61– 79
(2011). Somatoforme Störungen im Kindes- und Jugendalter: Analyse einer umstrittenen Störungskategorie aus entwicklungspsychopathologischer Sicht, Unveröffentlichte Dissertation, Unive,
(2010). Functional abdominal pain in childhood: From etiology to maladaptation. Psychotherapy and Psychosomatics, 79, 73– 86
(2011). Somatoform disorders: Thirty years debate about criteria. What about children and adolescents?. Journal of Psychosomatic Research, 70, 218– 228
(2004). Somatoform disorders: A help or hindrance to good patient care?. British Journal of Psychiatry, 84, 465– 467
(2010). Kinder mit Migräne und Asthma: Zur Rolle der Eltern-Kind-Interaktion. Kindheit und Entwicklung, 19volume>, 27– 35
(2006). Somatoform disorders and DSM-V: Conceptual and political issues in the debate. Psychosomatics, 47, 277– 281
(2007). Continuity of functional-somatic symptoms from late childhood to young adulthood in a community sample. Journal of Child Psychology and Psychiatry, 48, 508– 513
(2000). DSM-IV pain disorder: A case against the diagnosis. International Review of Psychiatry, 12, 91– 98
(2006). Somatoform disorders in DSM-IV: Mental or physical disorders?. Journal of Psychosomatic Research, 60, 341– 344
(2001). Doctor-parent-child communication. A (re)view of the literature. Social Science and Medicine, 52, 839– 851
(1995). Maternal factors and child’s health care use. Social Science and Medicine, 5, 623– 628
(2003). Health anxiety in children: Development and psychometric properties of the Childhood Illness Attitude Scales. Cognitive Behaviour Therapy, 32, 194– 202
