Functional somatic symptoms in childhood and adolescenceKozlowska, Kasiaa,b,cCurrent Opinion in Psychiatry: September 2013 - Volume 26 - Issue 5 - p 485–492 doi: 10.1097/YCO.0b013e3283642ca0 PSYCHIATRY, MEDICINE AND THE BEHAVIOURAL SCIENCES: Edited by Winfried Rief and Mohan Isaac Buy Abstract Author InformationAuthors Article MetricsMetrics 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
