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Children with psychosomatic symptoms 'should be checked for physical abuse'

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Healthcare staff should consider the possibility of physical abuse if a child presents with three or more psychosomatic events in a month, researchers have suggested.

Some 2,510 children aged 10, 12 and 15 from 44 schools across Sweden took part in a study which assessed whether they suffered from symptoms such as appetite and sleep issues and aches and pains.

There was an even split between the number of girls and boys in the study, which is published in Acta Paediatrica, with each age group roughly accounting for a third of the participants.

The research, carried out by experts at Karlstad University’s Division of Public Health Sciences, found that those who reported suffering from three or more such ailments within the same month were more than twice as likely to be being physically abused.

The association between three or more psychosomatic events and physical abuse was greatest among children who had also seen intimate partner violence (IPV), but there was no such link between multiple symptoms and witnessing IPV on its own, the researchers said.

Co-author professor Staffan Janson said: “The children were asked if they had experienced any of the following symptoms at least twice in the last month: stomach ache, headache, sleeplessness, dizziness, back pain and loss of appetite.

“They were also asked about 13 common chronic conditions, bullying and school performance, to eliminate any other factors that could cause the symptoms, and about whether they had been physically abused and witnessed IPV at home.

“Our study demonstrates a clear association between high levels of psychosomatic symptoms and an increased risk of physical abuse,” Professor Janson said.

“The association was even stronger in abused children who also witnessed intimate partner violence at home.

“The findings suggest that healthcare professionals should consider the possibility of physical abuse if a child presents with three or more regular psychosomatic symptoms a month.

“However, it is also important that they rule out any confounding factors, such as chronic illness, bullying and school performance when assessing the child.”

Multiple psychosomatic symptoms can indicate child physical abuse - results from a study of Swedish schoolchildren.

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