Medically Unexplained Symptoms and Chronic Medical Conditions

Information for Professionals


Referral to a child and adolescent psychiatrist can be helpful in clarifying the situation, particularly where multiple factors are involved and/or may offer ongoing therapy with the child, adolescent and family as part of the coordinated approach.
Many children and adolescents have physical symptoms that don’t have a serious medical cause. Sometimes these are linked to emotional factors, sometimes these are as simple as tummy pain in a younger child when they are worried about going to a new place or a headache before a big exam and settle without health professionals being involved. In many cultures physical expressions of psychological or emotional distress are regarded as the more acceptable way to express distress. On the other hand, when children or adolescents get stuck in physical symptoms that either cause ongoing distress and/or interfere with their ability to function at home or at school, assessment is appropriate.

Another group of children and adolescents may have chronic medical conditions along with emotional or behavioural symptoms or difficulties managing the medical condition that are influenced by relationships. These children may also have a mixture of symptoms that can and cannot be explained by their medical condition.

Treatment begins with ensuring that medical causes have been considered appropriately and then includes a coordinated approach with good communication to minimise unhelpful additional investigations and reduce the risk that new, significant medical concerns are missed. An assessment to consider factors that may be linked to the child or adolescents’ symptoms and then treatment of any specific disorders and a rehabilitation approach (focusing on function) is usually the most effective approach.