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Tijdschrift voor Psychiatrie 57 (2015) 10, 710 - 718

New research

Somatic screening in child and adolescent psychiatry: a descriptive pilot study

J.B. Muskens, K. Vermeulen, P.A.M. van Deurzen, E.M.A. Tomesen, R.J. van der Gaag, J.K. Buitelaar, W.G. Staal

background Somatic disorders occur more often in psychiatric patients than in the general population. Somatic symptoms can cause or increase psychiatric symptoms. Psychiatric symptoms and their treatment can have an effect on the physical state of the patient. A pilot study involving an adult outpatient population has demonstrated that 62% of the patients studied had new clinically relevant symptoms. So far, no other data are available relating to somatic screening in child and adolescent psychiatry.
aim To assess whether somatic screening of children and adolescents newly referred to a department of child and adolescent psychiatry in the Netherlands gives added value to the diagnosis and treatment policy.
method In a pilot study 43 newly referred patients aged between 6 and 18 were screened by means of somatic history, a physical examination and blood parameters. On this basis we could calculate the percentage of somatic symptoms and , where necessary, follow-up treatment could be applied.
results One or more clinically relevant disorders were found in almost 56% of the children and adolescents investigated. The disorders included dysmorphic anomalies, weight and height deviations, raised thyroid hormone levels, dyslipidaemia, anaemia and vitamin D and B12 deficiency. Advice about a healthy lifestyle was given to 44% of the patients. An antipsychotic medication in 25% of the patients was changed, in the case of 16% of the patients a family doctor was contacted about subsequent treatment and 19% of the patients were referred to a medical specialist.
conclusion Although the results of the pilot study indicate that somatic screening does provide added value, more research is needed in order to optimise the screening procedure.

keywords child and adolescent psychiatry, somatic disorder, somatic screening