Häufigkeit und Komorbidität Somatoformer Störungen bei Jugendlichen: Ergebnisse der Bremer Jugendstudie

Dissociative sensibility disorders - A retrospective case series and systematic literature review

CONTEXT

Dissociative disorders present a huge challenge in clinical settings. In contrast to other dissociative symptoms, dissociative sensibility disorders are rarely focused on.

OBJECTIVE

To identify the clinical characteristics and outcomes of dissociative sensibility disorders in children and adolescents, and to review the use of diagnostic procedures.

DATA SOURCES

For the review, a literature search used Pubmed, Embase, Web of Science, and PubPsych (to 02/2015) and the reference lists of the studies identified.

STUDY SELECTION

Screening of titles and abstracts; full-text assessment by two reviewers.

DATA SELECTION

The original case series was identified by using the local data register.

DATA EXTRACTION

Two reviewers independently reviewed the data and, if they agreed on the relevance, extracted the data. In the original case series, data were extracted retrospectively from the records.

RESULTS

Sixteen studies and seven case reports were identified, including 931 cases with dissociative disorders. In 210 cases the patient suffered either from a single sensibility disorder or predominantly from sensibility disorders. We identified thirteen further cases in our cohort. In both groups there was female predominance; the mean age of manifestation was early adolescence. The timing of admissions was variable. In approximately 50% of cases a premorbid stressful life event could be identified. Over 75% of cases had a good prognosis with complete resolution.

LIMITATIONS

Retrospective character of our own data collection, partially missing differentiation between the subgroups of dissociative disorders in the reviewed studies.

CONCLUSIONS

There is no uniform procedure for diagnostic work-up. The overall short-term prognosis is good.

[Functional abdominal pain in childhood]

Functional abdominal pain is one of the most common types of recurrent pediatric pain. This paper gives an overview of the etiopathogenesis, diagnostic criteria, and cognitive-behavioral intervention strategies for functional abdominal pain. It addresses the issues of organic causes, psychosocial stressors, and family and social conditions, as well as operant processes.

[Illness beliefs of children and adolescents with somatoform disorder or asthma bronchiale and of their parents]

Illness beliefs of children and adolescents (age: 8-18 years) with somatoform disorder or asthma bronchiale and of their parents were compared. 25 patients of each diagnostic group and their parents participated independently in semi-structured interviews. The answers were categorized after qualitative content analyses. The frequencies of specific illness beliefs in each group were compared, coefficients of similarity between patients' and their parents' illness beliefs were calculated. Illness beliefs are mostly multi-dimensional, but not consistent. We discriminated seven categories of causal attributions: genetic, mental, somatic, developmental, behavioural, social, and physical/environmental. Children and adolescents reported less complex attributions compared with their parents, moderate similarity between patients' and their parents' illness beliefs is demonstrated. Disease specific attributions were most prominent in the parental perspective, with a preference for psycho-social illness attributions in parents of patients with somatoform disorders and a preference for genetic, physical-external and somatic attributions in parents of patients with asthma. Patients with somatoform disorder considered significantly more often psycho-social illness causes, compared with patients in the asthma-group. Differential apriori assessment of patients' and parents' illness beliefs may contribute to effective cognitive-behavioral interventions.

Kreativ? Innovativ? Effizient? Defizient?

Zusammenfassung. Anhand der sorgfältig begutachteten Veröffentlichungen der letzten vier Jahre in der Zeitschrift für Klinische Psychologie und Psychotherapie werden Schwerpunkte und Schwachpunkte, Vielfalt und Einseitigkeit, Bewährung und Mängel, Effizienz und Defizite unseres Fachs deutlich. Diese Übersicht mündet in Anregungen und Wünsche, die sowohl in der Forschung als auch in den Veröffentlichungen Berücksichtigung finden sollten.