[Hospital admissions in adolescents with psychosomatic illnesses]. / Ingresos hospitalarios en adolescentes con enfermedades psicosomáticas.

OBJECTIVES: To determine the prevalence of hospital admissions due to psychosomatic diseases in the adolescents. To define the most frequent symptomatology that accompanies these disorders, the triggering factors, the complementary tests made and the possible existence of psychiatric illness in the parents. PATIENTS AND METHOD: A retrospective study was carried out with patients of 10 to 18 years who were admitted to the Niño Jesús Children's Hospital during the period from January 2002 to August 2006, whose discharge diagnosis included symptomatology of psychosomatic origin. RESULTS: The number of medical histories was 33. In this period the frequency of admissions due to psychosomatic diseases was 2.6 %. We found a predominance of female patients, with an average age of 11.5 years; the most frequent symptom was abdominal pain, isolated or accompanied by other pathology. The duration of the symptom before going to the hospital was 11 days. In 13/33 (39.4 %) of the cases previous symptoms of psychosomatic aetiology existed. The complementary study to discard organic disease was negative in all cases. The average stay was 5 days. The existence of triggering factors was found in 21/33 (63.6 %), school problems being the most common. In 7/33 (21 %) there was a family history of psychiatric disease. CONCLUSIONS: The most frequent somatic symptom was abdominal pain, being the triggering factor in most of the patients. The complementary study did not find significant abmormalities. In one out of five cases there was a family history of psychiatric disease. It is recommended to give these patients multidisciplinary care from the beginning of the stay, using consultation and link technique.

Ingresos hospitalarios en adolescentes con enfermedades psicosomáticas / Hospital admissions in adolescents with psychosomatic illnesses

Objetivos: Determinar la prevalencia de ingresos hospitalarios por enfermedades psicosomáticas en la edad adolescente. Definir la sintomatología más frecuente que acompaña a estos trastornos, los factores desencadenantes, las pruebas complementarias realizadas y la posible existencia de patología psiquiátrica en las figuras parentales. Pacientes y método: Se llevó a cabo un estudio descriptivo de tipo retrospectivo, durante el período comprendido entre enero de 2002 y agosto de 2006, en pacientes de 10 a 18 años ingresados en el Hospital Infantil Universitario Niño Jesús cuyo diagnóstico al alta incluía patología de origen psicosomático. Resultados: El número de historias recogidas fue de 33, lo que representa una prevalencia del 2,6 %. Se encontró un predominio de pacientes con sexo femenino, con edad media de 11,5 años, cuyo síntoma más frecuente fue el dolor abdominal aislado o acompañante de otra patología. La duración del síntoma antes de acudir al hospital fue de 11 días. En 13 de los 33 casos (39,4 %) existían síntomas previos de etiología psicosomática. El estudio complementario fue negativo en todos los casos. La media de ingreso fue de 5 días. Se encontraron factores desencadenantes en 21 de los 33 (63,6 %), de los cuales los problemas escolares fueron los más frecuentes. En 7 de los 33 (21 %) existían antecedentes de patología psiquiátrica familiar. Conclusiones: El síntoma somatomorfo más frecuente de ingreso en adolescentes fue el dolor abdominal, y existieron factores desencadenantes estresantes en la mayoría de los pacientes. El estudio complementario para descartar patología somática no encontró alteraciones significativas. En un caso de cada cinco existe patología psiquiátrica familiar. Es recomendable la atención al enfermo de forma multidisciplinaria desde el inicio del ingreso mediante técnicas de interconsulta y enlace

Objectives: To determine the prevalence of hospital admissions due to psychosomatic diseases in the adolescents. To define the most frequent symptomatology that accompanies these disorders, the triggering factors, the complementary tests made and the possible existence of psychiatric illness in the parents. Patients and method: A retrospective study was carried out with patients of 10 to 18 years who were admitted to the Niño Jesús Children's Hospital during the period from January 2002 to August 2006, whose discharge diagnosis included symptomatology of psychosomatic origin. Results: The number of medical histories was 33. In this period the frequency of admissions due to psychosomatic diseases was 2.6 %. We found a predominance of female patients, with an average age of 11.5 years; the most frequent symptom was abdominal pain, isolated or accompanied by other pathology. The duration of the symptom before going to the hospital was 11 days. In 13/33 (39.4 %) of the cases previous symptoms of psychosomatic aetiology existed. The complementary study to discard organic disease was negative in all cases. The average stay was 5 days. The existence of triggering factors was found in 21/33 (63.6 %), school problems being the most common. In 7/33 (21 %) there was a family history of psychiatric disease. Conclusions: The most frequent somatic symptom was abdominal pain, being the triggering factor in most of the patients. The complementary study did not find significant abmormalities. In one out of five cases there was a family history of psychiatric disease. It is recommended to give these patients multidisciplinary care from the beginning of the stay, using consultation and link technique

[Health examination of children from the Democratic Sahara Republic (North West Africa) on vacation in Spain]. / Examen de salud de niños de la República Arabe Saharaui Democrática (noroeste de Africa) de vacaciones en España.

OBJECTIVE: We present results of a global health evaluation of groups of children from the Democratic Sahara Republic who came to Spain for vacation. PATIENTS AND METHODS: Clinical and analytical tests of 242 Sahara children from refugee camps in Tindouf (Algeria) that were adopted temporarily by Spanish families between July 1993 and July 1997 are reported. We have used standard groups graphics from the World Health Organization. RESULTS: The results were as follows: sex, 53% girls; mean age, 11.1 +/- 1.6 years and age range, 7-16 years (mode 11). Sixty percent of the children had a weight lower than the 10th percentile and 28% less than the 3rd percentile. Fifty-one percent of the children had a height lower than the 10th percentile and 32% less than the 3rd percentile. The corporal mass was lower than the 10th percentile in 19% and less than the 3rd percentile in 8%. The mean hemoglobin was 12.7 +/- 1.2 gr/dl (17% Hb < 12), iron 66 +/- 32 micrograms/dl (23% Fe < 40), and ferritin 28 +/- 24 ngr/ml (26% Fe < 12). Between 1 and 3 intestinal parasites were found in 75% of the children. Isolated were: Entamoeba coli (38%), Blastocystis hominis (22%), Lamblia (18%), Endolimax nana (17%), Hymenolepis nana (11%), and Oxiuros (5%). Sixteen percent of the children had dental caries and 54% dental malocclusion. Ophthalmological problems were found in 28%, generally myopia. Mantoux > 9 mm was found in 5%. Other pathologies included: 5 kyphoscoliosis, 2 cardiopathies, 2 poliomyelitis sequels, 1 gastric ulcer, 1 epilepsy, 1 spherocytosis and 1 euthyroid goiter. Those with weight in p < 3 and/or functional murmur had Hb < 12 in 61% of the cases and Fe < 40 in 48%. CONCLUSIONS: Anamnesis is difficult because of ignorance of the pathological antecedents and date of birth. For physical exploration and collection of parasites they were extremely modest. Feeding and conditions of life would explain low weight and height percentiles, ferropenic anemia and intestinal parasite rates. It would be better to give anti-parasite drugs and systematic ferroprofilaxis as routine and perform blood tests only in those with weight p < 3.