Irritability is Common and is Related to Poorer Psychosocial Outcomes in Youth with Functional Abdominal Pain Disorders (FAPD) (original) (raw)
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Journal of Gastroenterology and Hepatology, 2008
Background and Aim: Functional abdominal pain syndrome (FAPS) is a functional gastrointestinal disorder. There is a heightened risk when conducting potentially dangerous and unnecessary medical investigations and procedures in children with FAPS. The aim of this study was to survey the rate of the psychiatric disorders and family functioning in children and adolescents with FAPS.Methods: The subjects were a consecutive new sample of 45 children and adolescents with FAPS, 45 with an organic abdominal pain, and 45 pain‐free comparison subjects aged 5–18 years that were interviewed using the Farsi version of K‐SADS. Family functioning and the severity of pain were also studied.Results: About 51.1% of patients with FAPS suffered from at least one psychiatric disorder. Psychiatric disorders in the FAPS patients studied included general anxiety disorder (8.9%), obsessive‐compulsive disorder (11.1%), attention deficit hyperactivity disorder (15.6%), separation anxiety disorder (24.4%), ...
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.
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.
Journal of the American Academy of Child & Adolescent Psychiatry, 2006
Objective: This prospective study characterizes trajectories of symptoms and impairment in pediatric patients with abdominal pain not associated with identifiable organic disease. Method: The Children_s Somatization Inventory and the Functional Disability Inventory were administered four times over 5 years to 132 patients (6Y18 years old) seen in a pediatric gastroenterology clinic. Individual trajectories were empirically grouped and correlates of trajectory group membership at baseline were evaluated. Results: A model with three unique trajectories was found to adequately fit both symptom and impairment data. Two trajectories indicated relatively long-term improvement and one indicated continued high levels of symptoms and impairment. At baseline, the long-term risk group did not have the most severe pain but had significantly more anxiety, depression, lower perceived self-worth, and more negative life events. Conclusions: These results indicate that several distinct trajectories of relatively long-term outcomes may exist in children with functional abdominal pain. One trajectory indicated long-term risk for a high level of symptoms and impairment. Psychosocial correlates of long-term risk for physical symptoms and impairment, such as child-reported stress and internalizing symptoms, may be useful for treatment planning. J. Am. Acad. Child Adolesc. Psychiatry, 2006;45(6):737Y744
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.
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.
Associations between abdominal pain symptom dimensions and depression among adolescents
Scandinavian Journal of Pain, 2014
Background and aims The prevalence of depression is increased among patients with abdominal pain (AP) and Irritable Bowel Syndrome (IBS), but little is known about this association among adolescents in the general population. Furthermore, there is considerable uncertainty about exactly which dimensions of AP and IBS are associated with depression. The aims of this study were therefore: (a) to describe the prevalence of AP, IBS and depression in a representative sample of adolescents, (b) to analyze the association of AP and IBS with depression and lastly, (c) to analyze the relationship between depression and specific AP and IBS symptom dimensions, i.e. pain intensity, frequency, duration, and distribution, the presence of co-morbid non-abdominal pain, and the specific bowel systems distinguishing IBS from AP in general. Materials and methods Self-reported symptoms of AP (monthly or more frequent), IBS (Rome III 2006 criteria), co-morbid chronic pain and depression (The Short Mood a...
Journal of Pediatric Gastroenterology and Nutrition, 2017
Objectives: To evaluate the feasibility and acceptability of the Aim to Decrease Anxiety and Pain Treatment (ADAPT), a brief, on-line and inperson behavioral intervention targeting pain and anxiety in youth with functional abdominal pain disorders (FAPDs). Methods: Patients were recruited from several outpatient pediatric gastroenterology clinics. Nine participants (ages 9-13) completed the full protocol. Thematic analysis of detailed qualitative feedback was obtained via semistructured patient and caregiver interviews after treatment was conducted. Feasibility and preliminary outcomes were examined using nonparametric tests. Results: Preliminary results indicate that the ADAPT treatment is feasible, acceptable, and potentially effective for youth with FAPD. Treatment completers reported that they enjoyed the program and used the skills to manage their pain and worry. Results also indicated that the majority of participants experienced a reduction in anxiety and several reported reductions in pain and functional disability levels. Conclusions: Findings from this study suggest that targeting both pain and anxiety may positively impact outcomes in youth with FAPD. The ADAPT intervention has the potential to provide a cost effective and practical application of cognitive behavioral therapy using an innovative combination of in-person and technology-based platforms. Overall, the ADAPT intervention is a promising and innovative intervention to improve the outcomes of youth with FAPD.
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.
Predictors of Abdominal Pain in Depressed Pediatric Inflammatory Bowel Disease Patients
Inflammatory Bowel Diseases, 2014
Background: Pediatric patients with inflammatory bowel disease (IBD) have high rates of abdominal pain. The study aims were to (1) evaluate biological and psychological correlates of abdominal pain in depressed youth with IBD and (2) determine predictors of abdominal pain in Crohn's disease (CD) and ulcerative colitis (UC).