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].

Hasil (Bahasa Indonesia) 1:

It is seldom an easy exercise to label pain symptoms in a child as functional. Even inabsence of any clinical signs, child needs to beinvestigated in view of severity of symptomsand disability caused by pain. Presence ofanxiety or depressive features does notexclude possibility of medical illnesses.Ongoing vigilance about all organicprobabilities of pain symptoms is definitelyindicated. Similarly, unindicated treatmentwith NSAIDS may harm the child’s health.Careful assessment is needed to establish thisdiagnosis [5]. Psychosocial factors are knownto play an important role in causation,maintenance, clinical severity andmanagement of these pain symptoms. Thesecomplex problems are thus best dealt with bymanagement by psychiatrist in liaison withpediatrician. At times both may co-exist.Some of the children in this study had sufferedorganic causes for pain like pain in abdomendue to acid peptic symptoms, or headache dueto sinusitis and so on. However, painsymptoms during current presentation werenot explained by these causes as perpediatrician’s assessment and were thusreferred to psychiatry department. 17 of the 59children in this study had such dual problems.Among these 5 (29.4 %) had depressiveepisode as against 12 out of 42 (28.5 %)without any medical co-morbidity (Chi square = 0.0639, p = 0.08004). Other psychiatric comorbiditieswere also comparable. Psychiatricillnesses have been reported to be moreumum pada anak-anak dengan medisdijelaskan sakit dibandingkan dengan medissakit menjelaskan dalam sastra [15].