Background: Unexplained medical symptoms are common in children. They constitute the main feature of somatoform disorders of childhood (i.e. pain disorders, conversion disorder and chronic fatigue syndrome or neurasthenia).

Objective: To describe assessment and treatment strategies for severe somatoform disorders of childhood.

Methods:  Review of recommendations for clinical practice and clinical trials.

Results:  A number of specific techniques have been described. Clinical accounts indicate that many children benefit and can recover. There is some empirical evidence supporting the beneficial effects of techniques such as family cognitive-behavioural therapy and relaxation technique for the less severe disorders.

Conclusions:  Existing helpful clinical guidelines require empiric validation.