Somatic Symptom or Related Disorder (SSRD)

What is it? 

Somatic Symptom or Related Disorder (SSRD), formerly Medically Unexplained Physical Symptoms (MUPS), is a disorder where symptoms cannot be fully explained by an identifiable physical cause or disease explaining the symptoms. Somatization is the process by which we experience a physical symptom of our emotional state. It is the body’s way of expressing stress and/or emotions.

Somatization happens to everyone. It can occur on its own or with a medical condition, or injury. Somatization becomes a disorder when it significantly disrupts a child’s daily life, preventing them from participating in school and other activities. Children may also suffer from anxiety, depression and eating disorders due to excessive worrying about their physical symptoms.

A somatic symptom is a physical symptom that occurs as a result of stress and/or emotions. For example, a child may often complain of a headache or an upset stomach before they go to school. This may be a sign that they are experiencing stress at school (e.g. bullying or fear of participating in a school activity).

What are the signs of Somatic Symptom Disorder in young children?

Emotions can show up in different physical ways in different people. Common symptoms include:

  • headaches
  •  abdominal pain
  • body aches 
  • dizziness
  • nausea
  • irritability
  •  poor sleeping habits 
  • poor appetite 
  • frequent urination

When is it time to seek professional help? 

Somatic symptoms may represent significant mental health challenges. They can be persistent and highly debilitating for children, leading to multiple medical consultations. It can cause major disruptions in a child’s daily life including their sleeping habits, eating habits as well as their school and family life.

What can be done?

An individualized, comprehensive and collaborative treatment plan should be made by members of the child’s care team. Depending on the child’s symptoms and their impact on the child’s life, they may be assessed by a range of healthcare professionals which include: 

  • pediatric specialists such as neurologists and gastroenterologists 
  • a dietitian 
  • rehabilitation specialists (e.g. occupational therapists, physiotherapists and speech and language therapists) 
  • mental health professionals (e.g. psychologists, psychiatrists and social workers)
  • a behavioural analyst

Medical assessments and treatment for any known medical condition(s) may be encouraged at the same time as treatment for somatic symptoms.

What makes some children more vulnerable to SSRD? 

Multiple factors have been associated with somatic symptoms which include stress, reduced coping skills, and family conflict. Children with adverse childhood experiences such as traumatic events, poverty, violence, abuse, neglect, and parental history of substance abuse are vulnerable to somatization. Research has also shown a strong association between somatic symptoms and anxiety/depressive disorders.

Where can I access support?

The child’s family doctor or pediatrician can help you find the right support and resources. The child may take part in different types of assessments to help understand the cause of their physical symptoms.  

Reach out to school administration, teachers and school counsellors for support. They can help recognize and respond to somatic symptoms appropriately. Symptoms should not be dismissed or believed to be fabricated. The school community can be instrumental in recognizing the timing, characteristics, triggers, and context of symptoms.  

Talk to the child’s guardianship worker to explore support services and resources.

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