Going to See the Paediatrician, 2020, Kozlowska et al

[Dolphin]

Free full text:
https://link.springer.com/chapter/10.1007/978-3-030-46184-3_2

The family, now very worried about Paula’s fatigue, had begun to wonder if Paula might also be suffering from chronic fatigue syndrome.

Looks like it could be quite annoying

Functional Somatic Symptoms in Children and Adolescents pp 19-36| Cite as

Going to See the Paediatrician

• Authors
• Authors and affiliations

• Kasia Kozlowska
• Stephen Scher
• Helene Helgeland

1. The Children’s Hospital at Westmead Disciplines of Child & Adolescent Health, and of PsychiatryUniversity of Sydney Medical SchoolSydneyAustralia
2. 2.McLean HospitalDepartment of Psychiatry, Harvard Medical SchoolBelmontUSA
3. 3.Department of Child and Adolescent Mental Health in HospitalsOslo University HospitalOsloNorway

Open Access
Chapter
First Online: 01 October 2020

Abstract

The paediatrician has a central role as a gatekeeper both in diagnosing functional somatic symptoms and in directing the child and family onto a path toward health and well-being.

In addition to determining that the child’s symptoms are not caused by a disease process, the paediatrician provides the child and family with a positive diagnosis that sits under the umbrella of functional somatic symptoms.

In so doing, the paediatrician validates the child’s symptoms; the family feel relieved and validated; and the child and family are ready to accept referral to a mental health clinician—or to a multidisciplinary team that treats functional somatic symptoms.

In this way, the paediatrician contributes to the creation of a secure base from which the child, family, and mental health clinician can feel safe enough to explore the various factors that contributed to the child’s presentation.

By contrast, when the clinical encounter with the paediatrician does not go well, the distressed family may end up consulting doctor after doctor, health professional after health professional.

As time passes, new symptoms arise; the child’s presentation gathers layer upon layer of complexity; and the child’s symptoms may become chronic and more difficult to treat.

 

[Arnie Pye]

I'm afraid that Abstract makes my skin crawl.

It seems to suggest that the first and most important duty of the paediatrician is to put in place a mental health diagnosis, and the issue of checking for treatable disease is an afterthought.

 

[Sean]

Shameless and irresponsible marketing spin.

This is my surprised face:

 

[Andy]

The paper title sounds like a book for children.

The paediatrician has a central role as a gatekeeper both in diagnosing functional somatic symptoms and in directing the child and family onto a path toward health and well-being.

And the wording here suggests one or the other - the paediatrician can diagnose a functional somatic symptom or they can direct the child and family onto a path toward health and well-being.

 

[Invisible Woman]

Underpinned by the idea that a mental health diagnosis, or treatment, inappropriately applied can't harm.

 

[chrisb]

And what if the family do not "feel relieved and validated"? Or is that not an alternative?

 

[Hoopoe]

As time passes, new symptoms arise; the child’s presentation gathers layer upon layer of complexity; and the child’s symptoms may become chronic and more difficult to treat.

That's what happens when disease progresses. Best to diagnose and treat it early and not waste time with magical psychosomatic thinking.