Putting is not sharp and open-ended questions ...

Putting is not sharp and open-ended questions to get information without the hassles of protective or reactive responses. For example, the possibility that some symptoms may worsen or triggirovatsya school stressors can be identified in the course of the conversation. The initial information about the connection between the symptom and the school can be obtained in the formulation of such questions: Pain is always there when you're in school or in the morning before school? Pain is always forcing you to abandon schooling? Follow the conversation can be directed to the identification of the extent to which the school is a source of stress for teenagers and as a teen responds to stress: · the way you walk to school? What assessment have you this year? - Do you think they are better or worse than last year? Why? • How do the last report card? • Which items are most difficult for you? What subject do you like most? · How many days have you missed this year? How you spend your day when you do not go to school? The answers to these questions will help identify the significant difficulties including evaluation of teachers, lack of schools and the possibility of secondary benefits of somatic symptoms. When a family history of treated adolescents with medically unexplained symptoms of view, we should examine if there was any history of similar symptoms in relatives or family members. Preceding a family disease associated with undiagnosed or serious illness can cause excessive parental concern about a minor complaint. The clinician should be alert to parental anxiety is manifested in such comments as "Aunt Doty had the same pain and she said it was from the head. They could not identify with her and that she died of cancer three months later. I would not want that to happen to my child. " In such cases, the parents should have more confidence in what must be considered and put a definitive diagnosis. Physical examination A thorough physical examination is an important part of the evaluation process. Parents must be convinced that what bothers them will be carefully examined to exclude the Physical causes of organic disease. Sometimes it can benefit the permit concerned parents watching the clinician when he is conducting a survey. Physical examination is usually normal in adolescents with psychosomatic complaints and, if possible, the clinician should point this out to his patient during the examination. For example, it sounds very convincing to inform the adolescent concern about possible cardiac causes of chest pain that his heart tones sound great, absolutely pure-Tide. Laboratory evaluation and other tests When teenagers go to the doctor, they and their parents usually rely on an organic explanation for somatic complaints. Many believe that for the detection of organic disease to conduct laboratory research.