Here's a video made by the coalition again paediatric pain featuring psychiatrist Richard barnum about the diagnosis of conversion disorder or somatoform disorder in children experiencing "unexplained" pain.
Here are some quotes:
9.53 Obviously, just from the point of view of validity of the diagnosis, if you have as a diagnostic criteria that there needs to be an underlying conflict that’s contributing to it, there’s something so non specific about that that you can’t possibly ever consider this to be a valid diagnosis, because people always have underlying conflicts.
10 41 In terms of the way this particuliar diagnosis is used routinely, it’s important to be aware that it’s almost never made on the basis of psychiatric assessment, or any other kind of mental health assessment, it’s almost always made on the basis of nothing more than failure to arrive at a clear medical diagnosis for the symptoms or functional deficit or whatever it is, and it’s made by non psychiatrist, by physicians who are puzzled and frustrated and that’s the only basis for it. … When the diagnosis is made it’s almost always in a manner that is quite careless and represents really nothing more than frustration and efforts to explain something that is essentially unexplained, unexplainable by the person making the diagnosis, and essentially put responsability on the patient’s unconscious.
12 40 There are incredibly profound problems with how this diagnosis gets used. Obviously in the first place, it leaves the actual medical problem unreckognised and untreated. The essential accusation of dishonesty that this diagnosis represents is compelingly distressing for patients. It undermines the patients own genuine subjective reality of what’s going on with them, it undermines the trust between doctor and patient. Espacially for children it’s explicitly powerfully traumatic to be accused essentially by a doctor who you trust and revere of being a lyer, dishonest. This is how patients experience being diagnosed with conversion disorder.
14 40 Obviously when you get into thinking about this in detail, the whole concept of developing this symptom or functional deficit as a result of unconscious mental processes, is just incredibly problematic. There’s no way to validate it, to make any sens of it. ….
15 10 The other obviously important difficulties with the way this diagnosis gets used is that it doesn’t do any good, not only does it do harm, but it doesn’t ever lead to effective treatment. I’ve never seen i’ve never heard of it from anyone that upon being diagnosed with conversion disorder the patient leaves the room with good ideas about how to proceed to get their symptoms releved through the process of whatever it might be in the way of psychiatric care.
And an interesting article by Judy Stone in Scientific American, with a frightening depiction of how Dr. David Sherry, a professor of pediatrics at University of Pennsylvania, treats children with POTS, considering it to be conversion disorder. She also speaks about Justina Pelletier's case.
http://blogs.scientificamerican.com...8/have-pain-are-you-crazy-rare-diseases-pt-2/
Please forgive my spelling, but my usual computer is out and the actual doesn't have an english corrector, and I'm really bad at english spelling.