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Functional somatic symptoms in childhood and adolescence

Kozlowska, Kasiaa,b,c

doi: 10.1097/YCO.0b013e3283642ca0
PSYCHIATRY, MEDICINE AND THE BEHAVIOURAL SCIENCES: Edited by Winfried Rief and Mohan Isaac

Purpose of review: Functional somatic symptoms (FSS) are common in children and adolescents, but explanatory models that synthesize research findings are lacking. This article reviews the studies published from January 2012 to March 2013 that investigate the neurophysiological mechanisms that may underlie FSS.

Recent findings: Studies from diverse medical disciplines suggest that FSS are associated with functional differences in hypothalamic–pituitary–adrenal function, imbalances in vagal-sympathetic tone, upregulation of immune-inflammatory function, and primed cognitive–emotional responses that serve to amplify reactivity to threatening stimuli, thereby contributing to the subjective experience of somatic symptoms.

Summary: FSS appear to reflect dysregulations of the stress system. When seemingly disparate research findings are interpreted together within an overarching ‘stress-system’ framework, a coherent explanatory model begins to emerge.

aPsychological Medicine, The Children's Hospital at Westmead

bBrain Dynamics Centre, Westmead, New South Wales

cDiscipline of Psychiatry, Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia

Correspondence to Kasia Kozlowska, MBBS, PhD, Child and Adolescent Psychiatrist, Psychological Medicine, Locked Bag 4001, Westmead, NSW 2145, Australia. Tel: +61 2 9845 2005; fax: +61 2 9845 2009; e-mail: kkoz6421@uni.sydney.edu.au;kasia.kozlowska@health.nsw.gov.au

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins