Abstract
Objectives: We investigated developmental disorders noticed only after the onset of psychosomatic disorders or maladaptive behaviors, by compairing them with cases in which such symptoms occurred after developmental disorders were diagnosed. Subjects: The study population comprised 70 pediatric patients with developmental disorder selected from among 691 children who visited the outpatient psychosomatic clinic of the Department of Pediatrics, between January 1993 and April 2002. Method: The subjects were divided into two groups: those with an established diagnosis of developmental disorder already made at the first visit, and those diagnosed as having the disorder only after the first visit. They were characterized by the type of disorder. Results: In the group with the diagnosis made only after the first visit, Asperger's disorder, pervasive developmental disorder not otherwise specified, and attention deficit/hyperactivity disorder were prevalent, showing higher incidences of reactive physical symptoms compared to the group with the previously established diagnosis. Additionally, because underlying developmental disorders had not been noticed, a vicious circle was evident in which the lack of appropriate management led to aggravation of symptoms. Conclusion: In the management of child with chief complaints of psychosomatic disorders or maladaptive behavior, it is important to bear in mind the possibility of developmental disorders.
