開業医が診る小児心身症 : 現状と対応(<特集>小児をめぐる心身医学)  [in Japanese] Childhood Psychosomatic Disorders Examined by a Practicing Physician : Current Status and Treatment(<Special Issue>Psychosomatic Disorders in Childhood and Adolescence)  [in Japanese]

1998年11月から約10年間に当院心身症外来を受診した15歳以下の患児558名(男子310名,女子248名,初診時平均年齢8.9±3.7歳)について調査し,開業医が診る小児心身症の現状とその対応について報告した.受診内容は,心身症(60.2%),行動の問題(17.0%),発達の問題(14.0%),不登校(8.8%)の4群に分けられ,全受診者の25.6%は発達障害を伴っていた.心身症の約60%は1年以内に治療を終了できたが,行動や発達の問題,不登校の約30%は治療を中断していた.対応には,子どもへの治療とともに家族への心理的ケアを行い,地域の他の相談機関とネットワークを形成して包括的支援を行うことが効果的であった.

The current status and treatment of childhood psychosomatic disorders were reported by a practicing physician examining 558 children aged 15 or younger who had visited our clinic as psychosomatic outpatients during the decade from November 1998 (310 boys and 248 girls, with a mean age of 8.9±3.7 at the first visit). The reasons for their visits were classified into four groups: psychosomatic disorders (60.2%), behavioral problems (17.0%), developmental problems (14.0%), and nonattendance at school (8.8%). Overall, 25.6% had developmental disorders. While treatment was completed within 1 year in about 60% of children with psychosomatic disorders, it was suspended in about 30% of those with behavioral/developmental problems or not attending school. Treatment for these children was more effective when psychological care was concurrently given to their families and a network with other counseling centers in the community is formed to provide comprehensive support.