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Measuring functional recovery in somatic symptom and related disorders: a scoping review
  1. Afiah Salsabila Winarizal1,2,
  2. Anita Horvath3,
  3. Susan M Sawyer1,4,5
  1. 1 Department of Paediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
  2. 2 Fakultas Kedokteran Universitas Indonesia, Jakarta, Daerah Khusus Ibukota Jakarta, Indonesia
  3. 3 Department of Medical Education, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4 Murdoch Childrens Research Institute, Parkville, Victoria, Australia
  5. 5 Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Professor Susan M Sawyer, Department of Paediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, VIC 3052, Australia; Susan.sawyer{at}rch.org.au

Abstract

Objective Somatic symptom and related disorders (SSRDs) are prevalent, heterogenous conditions that have the potential to profoundly affect normative function in children and adolescents. Yet there is little understanding of pathways to recovery. This study aimed to systematically scope how functional recovery has been measured in children and adolescents with SSRD .

Design Scoping review of primary studies.

Method Medline (Ovid) and PsychInfo were systematically searched for publications from January 1998 to April 2019. Primary studies in English that reported functional outcomes of children and adolescents with SSRD were included. Case reports and population studies were excluded. Within the tools and clinician notes, the core domains of functional outcome were identified.

Results Sixteen studies were identified that used 11 different functional outcome tools. The domains assessed within these functional outcome tools, together with the domains noted by clinicians, included physical and mental health symptoms, as well as school attendance and academic outcomes, recreational participation, impact on family and service utilisation. There was no evidence of a preferred outcome measure as only two of the tools were used in more than one study.

Conclusions The variability of tools and domains used to measure functional recovery in children and adolescents with SSRD suggests lack of conceptual agreement about what constitutes functional recovery. Continued focus on symptom measurement or mental health comorbidities risks limiting research to single types of disorder (eg, functional neurological disability) or interventions, which threatens a much needed wider research agenda around appropriate treatment, including of complex and persistent disorders.

  • adolescent health
  • child psychiatry
  • measurement
  • outcomes research
  • general paediatrics

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Footnotes

  • Twitter @SusanSawyer01

  • Contributors SMS conceptualised the study. All authors made substantial contributions to the study design. ASW screened the studies. ASW and AH independantly extracted data from each study. ASW and SMS drafted the paper. All authors critically reviewed the paper, approved the version published and agree to be accountable for the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Summary details of the reviewed studies are available in an Excel spreadsheet that details eligibility status of all screened studies and the extracted data from each of the included studies on request to the senior author.