Objective:

To evaluate clinical utility and feasibility of universal somatization screening in the pediatric emergency department (ED) using a standardized approach of (1) identifying potential somatizing symptoms within the ED, (2) introducing these patients and their caregivers to the concept of the ‘mind-body connection’, (3) corroborating the likelihood of a somatization diagnosis via brief psychiatric assessment, and (4) inviting families to a psychoeducational follow-up session.

Methods:

We conducted a cross-sectional study to carry out this approach with families visiting a pediatric ED. Our primary outcome of screening utility was measured as the proportion of youth who screened positive for somatization by the ED clinician. Our secondary outcome of screening feasibility was measured as the proportion of patients with positives who (1) agreed to meet with the study psychiatrist, (2) consented to an ED psychiatric assessment, (3) were assessed by the study psychiatrist as likely experiencing somatization, and (4) were invited for follow-up and attended.

Results:

Of the 344 screened patients, 27 (7.8%) screened positive for somatization. Of these, 25 (92.6%) families verbally consented to meet the study psychiatrist to learn about the mind-body connection, and 21 (77.8%) consented to further psychiatric assessment. Upon assessment, the somatization likelihood was supported for all 21 youth. Twenty families were invited to follow-up and ultimately two (10%) attended.

Conclusions:

Somatization can be detected through ED-based universal screening. Few families attended psychoeducational follow-up. Further research is needed to determine appropriate ED-initiated pediatric somatization intervention.

中文翻译：

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在儿科急诊科普遍筛查躯体化的效用：一项前瞻性评估

客观的：

使用标准化方法评估儿科急诊科 (ED) 普遍躯体化筛查的临床效用和可行性：(1) 识别 ED 内潜在的躯体化症状，(2) 向这些患者及其护理人员介绍“心智”的概念-身体联系'，（3）通过简短的精神评估来证实躯体化诊断的可能性，以及（4）邀请家庭参加心理教育后续会议。

方法：

我们进行了一项横断面研究，以对访问儿科 ED 的家庭实施这种方法。我们的筛查效用的主要结果被测量为由 ED 临床医生筛查出躯体化阳性的青年比例。我们筛查可行性的次要结果被测量为阳性患者的比例：（1）同意与研究精神科医生会面，（2）同意接受 ED 精神科评估，（3）由研究精神科医生评估为可能经历躯体化，和（4）被邀请跟进并出席。

结果：

在 344 名筛查的患者中，27 名（7.8%）的躯体化筛查呈阳性。其中，25 个（92.6%）家庭口头同意会见研究精神科医生以了解身心联系，21 个（77.8%）同意进一步进行精神评估。经评估，所有 21 名青年的躯体化可能性均得到支持。邀请 20 个家庭进行随访，最终有 2 个（10%）参加。

结论：

躯体化可以通过基于 ED 的通用筛查来检测。很少有家庭参加心理教育随访。需要进一步的研究来确定适当的 ED 发起的儿科躯体化干预。