Characteristics of adolescents presenting with physical symptoms without organic etiology at the pediatric emergency department in Martinique

BackgroundPhysical symptoms without an identified organic cause are frequently observed in adolescents. These symptoms are often linked to psychiatric comorbidities, posing diagnostic and management challenges for healthcare professionals. ObjectiveTo assess the proportion of pediatric emergency room visits for physical symptoms without organic etiology among adolescents with Patient Health Questionnaire-13 (PHQ-13) somatic symptoms. To assess the proportion of patients with somatic symptoms who received a psychosocial history, and describe the socio-demographic and clinical characteristics of these adolescents. MethodsQuantitative cross-sectional descriptive study of adolescents consulting the pediatric emergency department in Martinique from February 1, 2023 to April 30, 2024. Inclusion criteria were patients aged 11 to 17 years consulting with a somatic symptom of the PHQ-13 questionnaire. Medical management in the emergency department was considered satisfactory if a psychosocial history based on the HEADSSS questionnaire was taken. Results2398 emergency room visits were included. Analysis revealed that 42.2% of pediatric emergency consultations were related to symptoms without etiology. The majority of these consultations concerned girls (69.1 %, p[≤] 0. 05). The HEADSSS questionnaire was used in only 6.4 % of cases (p[≤] 0. 05). In our study, the most frequent physical symptoms without organic etiology were abdominal pain (35.7 %), chest pain (24.7 %) and malaise (24.7 %). ConclusionThis study shows that consultations related to physical symptoms without an identified organic cause found in adolescents are frequent in pediatric emergency departments in Martinique. Their management appears to be sub-optimal, and prospects for improvement should be considered, such as setting up a management protocol, training doctors in this area and carrying out further prospective and interventional studies.