Emotional abuse of children leading to somatoform disorder: a form of child abuse

Somatoform disorders are characterized by persistent physical symptoms without a demonstrable organic pathology or physiological explanation along with clinical indications that symptoms are linked to psychological factors or conflicts. In Sri Lanka, the grade five scholarship examination is a competition for parents in which they pressurize their children. This inserts psychological pressure on children causing traumatic experiences in their minds. This is a form of child abuse due to Munchausen syndrome by proxy (MSBP) and uses children to fulfill their gratifications, causing a severe degree of emotional abuse to the children and may result in somatoform disorders and children become victims of violence due to misbehaviour. When children are brought by parents alleging being assaulted by teachers for misbehaviour, the somatoform disorder should be considered.  These behaviours may not be explained by physical examinations, do not respond to treatments, and cannot be diagnosed by investigations but by psychological examination. Since it is a form of child abuse, the forensic medical officer has to use a multidisciplinary approach including organizing a case conference. Case conferences would help in the diagnosis of the condition, counselling of the parents, and educating the teachers to realize the impact of the problem and advise them to handle the problem empathetically.