We retrospectively reviewed the records of children hospitalized with a diagnosis of SSD from January 1, 2018, to December 31, 2021. Diagnoses of SSD were made by clinical psychologists or pediatric neuropsychiatrists trained in the field of somatic symptoms and related disorders in the developmental age, according to DSM-5 criteria. The psychopathological assessment of the included patients was performed using three standardized measures, validated for the use in children and adolescents in the Italian language:

Children’s Depression Inventory (CDI) is a self-assessment scale for depressive symptoms that can be administered to subjects of developmental age, between 8 and 17 years. It is made up of 27 items, with three alternative possibilities of response, graded on a scale from 0 to 2 points with increasing severity of the symptoms, which the subject is invited to choose based on the feelings of the previous 2 weeks; the total score will be between 0 and 54 points. It can be administered both individually and collectively and it can be completed in 15 min [21 ].

Self-Administered Psychiatric Scales For Children And Adolescents (SAFA) is a self-administered psychometric tool used to assess psychiatric comorbidities in children and adolescents. It is made up of six scales with different versions depending on the age group: 8–10 years “e”; 11–13 years “m”; 14–18 years “s.” It consists of an anxiety rating scale (SAFA-A), a depression rating (SAFA-D), an obsessive–compulsive symptom (SAFA-O), a psychogenic eating disorder (SAFA-P), one for somatic symptoms and hypochondria (SAFA-S), and finally one for phobias (SAFA-F) [22 ].

Revised Children’s Manifest Anxiety Scale—Second Edition (RCMAS-2) is a self-report tool consisting of 49 items to be administered both individually and in groups, which allows assessing the level and nature of the anxiety of children and young people aged 6 to 19. Through dichotomous questions, scores are provided for six distinct scales: physiological anxiety (FIS); concern (PRE); social anxiety (SOC); total anxiety index (TOT); defensive attitude (DIF); inconsistency index in responses (INC) [23 ].