Children and adolescents hospitalized for somatic symptoms: a retrospective cohort study

Purpose Somatic symptoms (SS) are physical manifestations associated with clinically significant distress that is disproportionate to or inconsistent with the history, physical examination, and other objective findings; they represent a notable reason for hospitalization in pediatric patients. The present study aimed to describe a cohort of pediatric patients hospitalized for SS. Methods We conducted a retrospective cohort study of children and adolescents hospitalized for SS in the Pediatrics Unit of Meyer Children’s Hospital IRCCS in Florence, Italy, from 2015 to 2024. Results One hundred and twenty-eight patients (male/female ratio 1/2.2; mean age 12 years) were hospitalized with SS over the study period, with a peak in annual prevalence in 2020–2021, corresponding to the COVID-19 pandemic. The most frequent manifestations at admission were musculoskeletal (40%), gastrointestinal (30%), and neurological (23%). Nearly half (49%) experienced symptoms involving multiple systems. The mean duration of hospitalization was 8 days. Magnetic resonance imaging was performed in 55% of patients, and computed tomography in 11%. Almost all (97%) received at least one consultation with a medical specialist, while 86% were assessed by a psychologist, psychiatrist, or both. Biopsychosocial risk factors (such as stressful family events and school absenteeism) were identified in 62%. Conclusion SS are common in children and adolescents and represent a frequent cause of hospitalization. Although awareness of SS is low among healthcare professionals, pediatricians play a key role in detecting and managing SS through a patient-centered approach and a multidisciplinary clinical pathway involving the psychologist and the psychiatrist.