It is seldom an easy exercise to la

It is seldom an easy exercise to label pain symptoms in a child as functional. Even in
absence of any clinical signs, child needs to be
investigated in view of severity of symptoms
and disability caused by pain. Presence of
anxiety or depressive features does not
exclude possibility of medical illnesses.
Ongoing vigilance about all organic
probabilities of pain symptoms is definitely
indicated. Similarly, unindicated treatment
with NSAIDS may harm the child’s health.
Careful assessment is needed to establish this
diagnosis [5]. Psychosocial factors are known
to play an important role in causation,
maintenance, clinical severity and
management of these pain symptoms. These
complex problems are thus best dealt with by
management by psychiatrist in liaison with
pediatrician. At times both may co-exist.
Some of the children in this study had suffered
organic causes for pain like pain in abdomen
due to acid peptic symptoms, or headache due
to sinusitis and so on. However, pain
symptoms during current presentation were
not explained by these causes as per
pediatrician’s assessment and were thus
referred to psychiatry department. 17 of the 59
children in this study had such dual problems.
Among these 5 (29.4 %) had depressive
episode as against 12 out of 42 (28.5 %)
without any medical co-morbidity (Chi square = 0.0639, p = 0.08004). Other psychiatric comorbidities
were also comparable. Psychiatric
illnesses have been reported to be more
common in children with medically
unexplained pain than those with medically
explained pain in literature [15].

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Itu adalah jarang latihan yang mudah untuk gejala nyeri label pada anak sebagai fungsional. Bahkan dalamketiadaan tanda-tanda klinis, anak harusdiselidiki dalam keparahan gejaladan ketidakmampuan yang disebabkan oleh rasa sakit. Kehadirankecemasan atau depresi fitur tidakmengecualikan kemungkinan penyakit.Kewaspadaan yang sedang berlangsung tentang semua organikprobabilitas dari gejala nyeri adalah pastiditunjukkan. Demikian pula, unindicated pengobatandengan OAINS dapat membahayakan kesehatan anak.Penilaian hati-hati diperlukan untuk membangun inidiagnosis [5]. Faktor-faktor psikososial dikenalmemainkan peran penting dalam penyebaban,pemeliharaan, tingkat keparahan klinis danManajemen gejala sakit ini. Inimasalah-masalah kompleks sehingga terbaik ditangani olehManajemen oleh psikiater dalam hubungan denganDokter anak. Kadang-kadang keduanya dapat berdampingan.Beberapa anak-anak dalam studi ini menderitaorganik penyebab sakit seperti nyeri di perutkarena gejala peptikum asam, atau sakit kepala jatuh temposinusitis dan seterusnya. Namun, rasa sakitgejala selama presentasi saat initidak dijelaskan oleh penyebab ini sebagai perDokter anak di penilaian dan dengan demikiandisebut Departemen Psikiatri. 17 dari 59anak-anak dalam studi ini memiliki masalah seperti ganda.Di antara 5 (29.4%) telah depresiepisode dibandingkan 12 dari 42 (28,5%)tanpa morbiditas rekan medis apapun (Alun-alun Chi = 0.0639, p = 0.08004). Comorbidities lain psikiatrimereka juga sebanding. Psikiatripenyakit telah dilaporkan untuk menjadi lebihumum pada anak-anak dengan medisdijelaskan sakit dibandingkan dengan medissakit menjelaskan dalam sastra [15].