Trajectories of Symptoms and Impairment for Pediatric Patients With Functional Abdominal Pain: A 5-Year Longitudinal Study (original) (raw)
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Variations in Psychological Profile Among Children with Recurrent Abdominal Pain
Journal of Clinical Psychology in Medical Settings, 2008
This study was designed to determine whether distinct subgroups of children with recurrent abdominal pain (RAP) could be identified based on patterns of psychological functioning. Two hundred and eighty-three children (ages 8-17 years), and a primary caretaker, completed the Behavior Assessment System for Children (BASC) during the initial evaluation of RAP at a pediatric gastroenterology clinic. Cluster analysis of BASC scores supported a 3-cluster solution, with fair agreement observed between parents and children on cluster assignment. Approximately half of the sample identified no significant psychological problems. A small percentage (13%) evidenced intense and broad-based psychological problems, while the remainder (35-45%) indicated relative elevations in anxiety only. Cluster membership did not vary systematically by age, gender, race, or functional gastrointestinal disorder diagnosis. Distinct psychological profiles appear to exist for children with RAP. Targeting treatments to these profiles may improve the effectiveness and efficiency with which health professionals address pediatric abdominal pain.
The Role of Psychosocial Factors in Children with Recurrent Abdominal Pain
Pediatrics & Therapeutics, 2013
Background: Chronic, recurrent abdominal pain (RAP) is common in children and adolescents where it impacts on everyday life, causes absence from school, and leads to frequent medical consultations. Aims: to establish to what extent psychosocial factors and negative life events can be identified in children with RAP. Methods: we investigated 78 children with functional abdominal pain (age 5-14 y). One hundred thirty-one healthy schoolchildren acted as controls. Questionnaires were used for to assess psychological symptoms, negative life events and socioeconomic factors. The psychological assessment comprised 3 clinical scales (Depression, Anxiety and Behavior) totaling 35 items and was answered by the parents. Scores were calculated (separately and totally) and correlated with those of controls. Results: Family movement, economic difficulties and low socioeconomic status correlated significantly with RAP (p<0.05). Children manifested, more frequent anxiety, depression indicative factors (dysthymic depression, attitude derangement) and behavior derangement (p<0.05). Conclusions: Psychological factors, low socioeconomic status, family movement and severe economic difficulties were found significantly more frequently in children with functional abdominal pain and may well influence symptoms expression in childhood.
Psychosocial Correlates of Recurrent Abdominal Pain in Paediatric Patients
https://www.ijrrjournal.com/IJRR\_Vol.5\_Issue.3\_March2018/Abstract\_IJRR002.html, 2018
Background: Recurrent abdominal pain (RAP) is a very common distressing complaint in the pediatric population. Etiology remains an enigma as in majority of the cases the cause is not identified and therefore these cases are considered to be functional in origin. Aims: To study psychological and social correlates in children with RAP and use of standardized scales to assess functional disorders (Anxiety state, anxiety Trait, and depression) and to see the association of negative life events in these patients. Methods: We enrolled 49 children (age 5-12 yrs.) with complaint of recurrent abdominal pain, out of which 6 were excluded having organic cause of pain. These 43 cases termed as functional cases of RAP were compared with 40 control children of same age group. Standardized scales were used to define psychological disorders (vide supra) and negative life events and other stressors. Mean score of these factors were compared with that of control group. Results: Out of 43 cases 8 patients (5 cases anxiety state, 2 cases anxiety state+anxiety trait and 1 case of depression) were found to have psychological disorders which were significantly higher than control groups. When we compared mean scores of anxiety state, anxiety trait and raw scores of depression, we found positive correlation of anxiety trait and depression in RAP group. Our study failed to establish positive correlation with negative life events in patients with RAP. Conclusion: Our study showed not only a significant anxiety disorder in the cases but also a higher mean anxiety trait scores and higher depression raw scores than control. Therefore, it is suggested that such cases maybe followed up for development of anxiety or depression later.
PEDIATRICS, 2005
Objective. Recurrent abdominal pain (RAP) is a common problem in children and adolescents. Evaluation and treatment of children with RAP continue to challenge physicians because of the lack of a psychometrically sound measure for RAP. A major obstacle to progress in research on RAP has been the lack of a biological marker for RAP and the lack of a reliable and valid clinical measure for RAP. The objectives of this study were (1) to develop and test a multidimensional measure for RAP (MM-RAP) in children to serve as a primary outcome measure for clinical trials, (2) to evaluate the reliability of the measure and compare its responses across different populations, and (3) to examine the reliabilities of the measure scales in relation to the demographic variables of the studied population.
Romanian Journal of Pediatrics
Both functional abdominal pain and irritable bowel syndrome are common causes of chronic abdominal pain in children and adolescents. Addressing these nosological entities is done according to the biopsychosocial model of functional gastrointestinal disorders, given their effect on quality of life and psychosocial status thereof. The cognitive-behavioral therapy, family psychotherapy, relaxation techniques or hypnotherapy have proved effective in achieving better coping mechanisms in alleviating psychological and somatic symptoms. However, antidepressant medication including selective serotonin reuptake inhibitors and tricyclic antidepressants, improve psychiatric symptomatology, especially depressive mood due to gastrointestinal illness, but also digestive symptoms due to mechanisms of action that depend on complex neurotransmitters.
Perceptions of Pain Treatment in Pediatric Patients With Functional Gastrointestinal Disorders
The Clinical Journal of Pain, 2020
Objectives: Individual understanding of and expectations for chronic pain treatment can influence treatment adherence and thus success, but little is known about these critical factors in parents and children presenting with pain-predominant functional gastrointestinal disorders. The aim of this study was to identify parent and patient understanding of pain-predominant functional gastrointestinal disorders, expectations for treatment, and interventions utilized before presenting to a multidisciplinary clinic. Materials and Methods: This was a prospective study of patients evaluated in a Multidisciplinary Functional Abdominal Pain Program. Before the clinic visit, parents and patients completed questionnaires regarding their understanding of chronic pain, perceptions of abdominal pain contributors, expectations regarding treatment, and identification of previous interventions utilized. Results: Participants were knowledgeable regarding the biology of chronic pain. Perceptions of contributors to abdominal pain included a sensitive stomach, general stress, and nerves/worry. Most had attempted to treat their pain with medication, exercise or physical therapy, or a psychological treatment. Participants reported that receiving a definite diagnosis would be the most helpful intervention, followed by psychological treatment. Discussion: Participants were knowledgeable regarding chronic pain, but still indicated that receiving a definite diagnosis would be the most helpful intervention. Most had tried multiple interventions and did not believe that further medication, testing, or surgery would solve their pain. Instead, parents presenting at this Functional Abdominal Pain Program appeared most hopeful about the benefits of multidisciplinary treatment approaches including psychological interventions, a focus on activity and functioning, and complementary and alternative medicine interventions.
Psychological Correlates of Depression in Children with Recurrent Abdominal Pain
Journal of Pediatric Psychology, 2006
Objective To examine the associations between coping style, social support, self-efficacy, locus of control, maternal adjustment, and depressive symptoms in children with recurrent abdominal pain (RAP) of childhood. Methods Fifty children with RAP (8-18 years) and their mothers were recruited from a gastroenterology clinic (GI) and community medical practices. Participants completed questionnaires that assessed coping style, social support, self-efficacy, locus of control, maternal adjustment, and psychological adjustment. Results Passive coping strategies such as isolating oneself from others, catastrophizing, and behavioral disengagement were associated with more child-reported depressive symptoms. Higher levels of self-efficacy and greater social support from teachers and classmates were associated with fewer child-reported depressive symptoms. Higher levels of maternal adjustment problems, higher social support from parents, and lower social support from classmates were associated with maternal reports of more child internalizing symptoms. Conclusions These findings suggest that coping style, self-efficacy, social support, and maternal adjustment are correlates of depressive symptoms in children with RAP.
Psychological aspects of Recurrent Abdominal Pain Syndrome in children
PubMed, 2015
Introduction. Intermittent visceral distress syndrome is described as "at least three scenes of visceral distress, sufficiently severe to hinder their actions over a time longer than 3 months, continuing from the preceding year". Organic factors causing abdominal pain are rare, so most of the children with an intermittent visceral distress are designated to have a functional abdominal pain. This study was designed to evaluate psychological problems such as anxiety and distress in children with functional intestinal distress. Method. 120 children (50 boys and 70 girls) with an age range of 5-18 years, who complained of abdominal pain among other things, were included in this cross-sectional case-control study (forty with an organic etiology, 38 diagnosed as RAPS and 42 healthy controls). Revised Children's Manifest Anxiety Scale (RCMAS) questionnaire and Depression Self-Rated Scale (DSRS) questionnaire were used to determine the level of anxiety. A 28-question General Health Questionnaire (GHQ-28) was also used to investigate the general mental health of their mothers. Result. In the present study, organic and functional etiology of abdominal pain was significantly different with regard to the anxiety score. However, this was not seen as far as depression was concerned. The total GHQ score of mothers was not significantly different between the three groups. ANOVA was used to compare groups. Conclusion. As shown in the present study, that is consistent with most other studies, psychological factors were seen in RAP and need a more in depth investigation to be resolved.
Journal of Pediatric Gastroenterology & Nutrition, 2011
Objectives-Nongastrointestinal (non-GI) somatic complaints are common in children and adults with functional gastrointestinal disorders (FGIDs). The aim of the present study was to determine whether non-GI somatic complaints in children with functional abdominal pain (FAP) were associated with FGIDs in adolescence and young adulthood. Patients and Methods-In a prospective clinic-based study, children and adolescents (ages 8-16 years) with FAP (n = 188) and well controls (n = 61) completed a validated measure of somatic symptoms. Participants were assessed 4 to 15 years later (as older adolescents and young adults) for presence of current FGIDs as defined by the Rome III criteria. Results-Of the 188 youths with pediatric FAP, 35.6% met criteria for FGIDs at follow-up. Initial levels of non-GI somatic symptoms were significantly higher in pediatric FAP participants who subsequently met criteria for FGIDs at follow-up compared with controls and pediatric FAP participants who did not meet criteria for FGIDs at follow-up. Conclusions-The association of non-GI somatic symptoms with FAP in children may identify a group that is at risk for FGIDs later in life. Keywords adolescents; children; chronic abdominal pain; follow-up; gastrointestinal; somatic symptoms Chronic or recurrent abdominal pain affects 8% to 25% of healthy school-age children (1-3) and is characterized by continuous or episodic abdominal pain. In most cases, the pain is functional-it cannot be adequately explained by structural or biochemical abnormalities (4). Pediatric functional abdominal pain (Ped-FAP) persists throughout development in a significant proportion of children (1,5-8) and has been linked to functional gastrointestinal disorders (FGIDs) such as irritable bowel syndrome in adulthood (7,9,10).