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The custody fight started with that visit: At Boston Children’s Hospital, doctors assessed Justina, then 14, and diagnosed somatoform disorder, a mental health condition related to stress.

However, when she came to Boston Children’s Hospital, doctors there said she was suffering from a somatoform disorder, which is a psychological condition.

“When people have unexplained pain, pelvic pain, it’s called somatoform dissociation,” he said, “and the only way her body, which was suffering during those early experiences, can tell its tale of woe is with pain. And she really needs to see a trauma specialist, not a urologist. Know what I’m saying?”

Patients also filled out a psychiatric questionnaire, asking them about depression, anxiety and symptoms of somatoform disorder — a condition in which a person's physical symptoms cannot be traced to a medical cause and are instead due to psychological factors.

Most common were anxiety, dissociative and so-called somatoform disorders -- a group of disorders with physical symptoms but no apparent physical cause.