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Recurrent abdominal pain, anxiety, and depression in primary care
Author(s) -
Ramchandani Paul
Publication year - 2004
Publication title -
child: care, health and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.832
H-Index - 82
eISSN - 1365-2214
pISSN - 0305-1862
DOI - 10.1111/j.1365-2214.2004.00456_1.x
Subject(s) - anxiety , psychiatry , depression (economics) , medicine , abdominal pain , clinical psychology , pediatrics , psychology , economics , macroeconomics
Recurrent abdominal pain, anxiety, and depression in primary care.
Campo JV , Bridge J , Ehmann M , Altman S , Luca A , Birmaher B , Di Lorenzo C , Iyengar S & Brent D.
(2004)Pediatrics,113,817–824.Objective The prevalence of psychiatric disorder in children and adolescents with functional recurrent abdominal pain (RAP) is unknown. Our aim was to determine whether RAP is associated with psychiatric symptoms and disorders, anxious temperament and functional impairment in paediatric primary care. Methods Children and adolescents who were 8–15 years of age, inclusive, and presented with RAP ( n = 42) or for routine care in the absence of recurrent pain ( n = 38) were identified by a screening procedure in paediatric primary care office waiting rooms and recruited to participate in a case–control study. Outcome measures were psychiatric diagnoses generated by standardized psychiatric interview administered blind to subject status and self, parent and clinician ratings of child psychiatric symptoms, temperamental traits and functional status. Results RAP patients were significantly more likely to receive a diagnosis of a psychiatric disorder, with a categorical anxiety disorder in 33 (79%) and a depressive disorder in 18 patients (43%), and higher levels of anxiety and depressive symptoms, temperamental harm avoidance and functional impairment than control subjects. Anxiety disorders [mean age of onset: 6.25 (standard deviation: 2.17) years] were significantly more likely to precede RAP [mean age of onset: 9.17 (standard deviation: 2.75) years] in patients with associated anxiety. Conclusions Youths who present with RAP in primary care deserve careful assessment for anxiety and depressive disorders. Future studies should examine treatments that are proved to be efficacious for paediatric anxiety and/or depressive disorders as potential interventions for RAP. Longitudinal, family and psychobiological studies are needed to illuminate the nature of observed associations among RAP, anxiety and depression.