RT Journal Article SR Electronic T1 Patterns and seasonality in pediatric referrals for functional somatic symptoms JF Journal of Investigative Medicine JO J Investig Med FD BMJ Publishing Group Ltd SP jim-2021-002252 DO 10.1136/jim-2021-002252 A1 Pepijn den Braber A1 Joris van Driel A1 Dorien Broekhuijsen A1 Bert Wienen A1 Jolita Bekhof YR 2022 UL http://hw-f5-jim.highwire.org/content/early/2022/06/30/jim-2021-002252.abstract AB Functional somatic symptoms (FSS), or medically unexplained physical symptoms, are common in children and it has been suggested that the incidence is increasing. To determine the incidence and pattern of referrals for FSS to pediatricians, we performed a retrospective analysis including newly referred pediatric patients to our secondary pediatric practice in Zwolle, The Netherlands, ultimately diagnosed with FSS between 2013 and 2018. FSS was defined as functional abdominal pain, chronic fatigue, chronic musculoskeletal pain and chronic headache without an underlying medical diagnosis. In the 6-year period, 10.4% of elective referrals were related to FSS without a significant upward trend. We found clear seasonal variation with peaks in incidences in March (+31%) and November (+21%) and a nadir around August (−48%). In conclusion, FSS account for 1 in 10 non-acute pediatric referrals, without an increase in incidence in the past 6 years. The seasonal pattern is remarkable and warrants further analysis.Data are available on reasonable request.