Opinion/Feedback

Within the framework of cooperation between the physical medicine and rehabilitation (PMR) department and psychiatry department in our establishment with care and education, we have created in 2006 a unit with both somatic and psychic care, allowing management of preadolescents and adolescents suffering from complex somatoform disorder with pain in full-time hospitalization. They have chronic pain associated with motor exclusion of a limb, which have for consequence a participation restriction on scholar and extra-scholar activities with a larger impact than it should be.

We describe our retrospective experience about a cohort of 43 patients who suffered from this disease with a length of stay of several months. We give a definition of this disorder in terms of international classifications and detail the semiology. We issue some clinical and psychopathological assumptions to better understand these particularly disconcerting events, which need technical and interdisciplinary management. The link is discussed between major depression masked by invalidant somatic symptoms and secondary discovery of school phobia. We formulate the psychopathological assumption of an addiction behavior according to criteria of S. and A.N. Sussman for highlighting the clinic semiology and evolution of our patients in the institutional process.