mapping the healthcare pathway to multidisciplinary assessment of 12-25 year olds with somatic symptom disorder

Conditions: Somatic Symptoms; Medically Unexplained Symptoms; Somatoform Disorders

Summary: this study aims to describe the course of successive care events that follow individuals with somatic symptom disorder until they are assessed by a specialized multidisciplinary team. data is collected during interviews with subjects aged 12 to 25 years old accompanied by their parents. a biographical grid is used to retrospectively identify all care events that occurred from first symptoms until multidisciplinary assessment. life events and symptoms are collected as well to explore how history of healthcare consumption is linked to other trajectories. a qualitative analysis of the recorded interviews aims to describe the subjective experience of this healthcare pathway.

somatic symptom disorders (ssd), previously labelled somatoform disorders, are known to challenge healthcare professionals and systems, as those common conditions reducing quality of life often lead to excessive referrals and investigations before adequate diagnosis and management. although studies have proved multiple interventions to be effective and cost-effective in various clinical settings, little is known about the accurate healthcare utilization associated with ssd. such analysis faces the complexity of ssd detection and labelling due to heterogeneous clinical presentations and disputed cross-disciplinary classifications. even though healthcare is known to be a core theme of patient experience of ssd, the investigators lack data describing the trajectory of care and the expectations, perceived help and triggering events associated with healthcare services use. a better understanding of the healthcare pathway those patients follow will help implement evidence-based treatment effectively. the aim of this study is to trace back the pathway of care that individuals follow before they eventually undergo a specialised multidisciplinary assessment. this descriptive study relies on data retrospectively collected from patients and their parents during face-to-face interviews assisted by a biographical grid. inclusion criteria for patients are to be aged 12 to 25 years old and to be diagnosed with ssd by a specialised multidisciplinary team. variables measured to describe the healthcare pathway are chosen according to professional experience and literature review. they are collected alongside concomitant life events both to reduce memory bias and to explore determinants and effects of healthcare consumption as a secondary outcome. the subjective experience of this healthcare pathway described by patients and their parents is analysed qualitatively in the verbatim of the audio recorded interview.

Eligibility criteria:
inclusion criteria: criteria relating to the population studied: * age between 12 and 25 years old * diagnosis of somatic symptom disorder and derivatives (dsm 5) after specialized multidisciplinary evaluation by the team of the maison des adolescents of cochin hospital (maison de solenn). criteria relating to the additional population participating in the research: - being a parent of a subject who has received the diagnosis of somatic symptom disorder and derivatives (dsm 5) after specialized multidisciplinary evaluation at the maison des adolescents of cochin hospital (maison de solenn). exclusion criteria: criteria relating to the population studied: * age less than 12 years or greater than 25 years at the time of assessment, * subject presenting ongoing psychiatric decompensation, that is to say a state of mental health breaking with their baseline state and requiring rapid care which does not allow a research interview to be carried out. criteria relating to the additional population participating in the research: none

Keywords: somatic symptoms somatoform disorder medically unexplained symptoms healthcare pathway healthcare trajectory care episodes health care utilization adolescent young adult