DSM-5 Danger: Misdiagnosis of Physical Conditions in Your Anxious Child

Ill childThe phrase “It’s all your head” can definitely ring true for many adults and children alike who suffer from anxiety disorders. Mental anguish can indeed manifest as physical, or somatic, symptoms or even be diagnosed as somatic symptom disorder (SSD). Several may already be familiar with such symptoms from firsthand experience with your own or your anxious child’s ailments.

How many times has stress given you a headache or an upset stomach? Has your anxious child ever started sweating or having heart palpitations as a direct result of his anxiety?

On the other hand, there are other times when the physical symptoms do not stem from mental anguish but instead are truly signs of a physical health problem.

Don’t look for the updated version of the Diagnostic and Statistical Manual of Mental Disorders to make the boundaries clear. The new DSM-5, due out in May and outlined in our complete guide to DSM-5, leaves a vague definition of SSD that critics charge can result in clumping those with actual physical ailments into the wrong category and thereby delaying or even annihilating any chance of proper medical treatment.

“DSM-5 defines SSD so over-inclusively that it will mislabel one in six people with cancer and heart disease, one in four with irritable bowel syndrome and fibromyalgia, and one in 14 who are not even medically ill,” says Duke University Professor Emeritus Allen Francis, one of the more vehement critics of the issue.

How this Can Affect Children with Anxiety

Anxious children are no strangers to physical symptoms that may appear to be related to a physical condition or disease but are in reality stemming from their anxiety issues. But that doesn’t mean they are never going to be affected by physical conditions that demand medical care that goes far beyond stress relief techniques, therapy and other mental health treatments.

A study published in the Journal of the American Academy of Child and Adolescent Psychiatry reinforced that anxious children often exhibit physical symptoms that are not associated with any physical condition.

“(Somatic symptoms) are highly prevalent among children and adolescents with anxiety disorders and are associated with greater anxiety severity and impairment,” the study reported. 

The most prevalent somatic symptoms the researchers noted included:

  • Restlessness: 74 percent
  • Stomachaches: 70 percent
  • Blushing: 51 percent
  • Palpitations: 48 percent
  • Muscle tension: 45 percent
  • Sweating 45 percent
  • Trembling and/or shaking: 43 percent

Those same symptoms, however, may also be present with a variety of physical conditions and ailments. This same study also had issue with the SSD definition, calling for re-evaluation of the version found in DSM-IV to help reduce the chances of misdiagnosis.

Evidently that’s not happening.

Despite the “simple wording changes” Frances said he suggested in a detailed letter to the DSM-5 committee, the boundaries between physical symptoms stemming from physical ailments and those stemming from mental disorders remain hazy.

Frances writes, “The sad result will be the mislabeling of potentially millions of people with a fake mental disorder that is unsupported by science and flies in the face of common sense.”