School absenteeism as a potential proxy of functionality in pediatric patients with somatic symptom and related disorders

Little is known about the school functioning of youth who are medically admitted with somatic symptom and related disorders (SSRD). The current study examines school absenteeism and associated factors in medically hospitalized children and adolescents with SSRDs. Retrospective data were reviewed of 243 patients aged 5 to 18 years admitted at a pediatric hospital from 2012 to 2014, referred to the Psychiatry Consultation Service and diagnosed with an SSRD. Only 10% of patients had normal school attendance in the past year and approximately 40% had severe school absenteeism (i.e. missed > 1 month of school). No association was found between school absenteeism and caregiver report of learning difficulties/disabilities. Patients with severe school absenteeism were more likely to be between the ages of 15 and 17, with higher somatization and functional disability scores, higher rates of suicidal ideation and/or attempts, greater psychotropic medication use and psychiatry sessions during admission, and greater rates of discharge to a higher level of psychiatric care. Findings from this study suggest that screening for school absenteeism during clinical visits by use of a single question "how many school days have you (or has your child) missed this past school year," may serve as a proxy for functional disability and an indicator of psychiatric, and somatic symptom severity concerns.