Anxiety and Somatic Complaints in Children with Recurrent Abdominal Pain and Anxiety Disorders

Dufton, Lynette; Dunn, Madeleine J.; Compas, Bruce E.

doi:10.1093/jpepsy/jsn064

Cited by 128 publications

(106 citation statements)

References 27 publications

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“…This study extends the literature linking pediatric FAP to anxiety disorders 7,10,11,50 with prospective data showing that patients with FAP continue to experience high rates of anxiety disorders into adolescence and young adulthood. Patients with FAP also had high rates of depressive disorders during their lifetime, but few met criteria for a depressive disorder at the time of follow-up.…”

Section: Discussionsupporting

confidence: 74%

“…9 In addition, pediatric patients with FAP have high rates of anxiety and depression. 10,11 Although several studies have evaluated the persistence of abdominal pain in patients with FAP, 12 only 1 study evaluated diagnostic criteria for psychiatric disorders in these patients when they reached adulthood. In their seminal study, Campo et al 13 identified 28 pediatric patients with medically unexplained recurrent abdominal pain by retrospective chart review and conducted telephone interviews with these patients when they were young adults.…”

Section: Discussionmentioning

confidence: 99%

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Functional Abdominal Pain in Childhood and Long-term Vulnerability to Anxiety Disorders

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: At the time of their pediatric medical evaluation, patients with functional abdominal pain (FAP) have higher levels of emotional symptoms compared with youth without FAP. No controlled prospective study has evaluated psychiatric outcomes for FAP patients in adulthood. WHAT THIS STUDY ADDS:This prospective study showed that pediatric FAP was associated with high risk of anxiety disorders in adolescence and young adulthood. Risk was highest if abdominal pain persisted, but was significantly higher than in controls even if pain resolved. abstract BACKGROUND: Cross-sectional studies link functional abdominal pain (FAP) to anxiety and depression in childhood, but no prospective study has evaluated psychiatric status in adulthood or its relation to pain persistence.METHODS: Pediatric patients with FAP (n = 332) and control subjects (n = 147) were tracked prospectively and evaluated for psychiatric disorders and functional gastrointestinal disorders (FGIDs) at followup in adolescence and young adulthood (mean age = 20.01 years). Participants were classified according to presence (FGID-POS) or absence (FGID-NEG) of FGIDs at follow-up.RESULTS: Lifetime and current risk of anxiety disorders was higher in FAP than controls (lifetime: 51% vs 20%; current: 30% vs 12%). Controlling for gender and age, the odds ratio was 4.9 (confidence interval = 2.83-7.43) for lifetime anxiety disorder and 3.57 (confidence interval = 2.00-6.36) for current anxiety disorder at follow-up for FAP versus controls. Lifetime risk of depressive disorder was significantly higher in FAP versus controls (40% vs. 16%); current risk did not differ. In most cases, initial onset of anxiety disorders was before pediatric FAP evaluation; onset of depressive disorders was subsequent to FAP evaluation. Within the FAP group, risk of current anxiety disorders at follow-up was significantly higher for FGID-POS versus FGID-NEG (40% vs 24%), and both were higher than controls (12%); current depressive disorders did not differ across FGID-POS, FGID-NEG, and controls. CONCLUSIONS:

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Functional Abdominal Pain in Childhood and Long-term Vulnerability to Anxiety Disorders

et al. 2013

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“…Even though most children with frequent AP are lacking explanatory organic diseases [1] and a substantial proportion of children exhibits psychological problems [14,17,52], it cannot be concluded that frequent nonorganic AP is caused by psychological factors [11]. FGIDs are thought to be strongly linked to a disordered brain-gut interaction [13]: Stress and unpleasant emotional states lead to hypervigilance and hence to an increase of arousal of the autonomous nervous system and the endocrine system, which may contribute to a heightened sensitivity of the gut and modified gut motility [13,31].…”

Section: Discussionmentioning

confidence: 99%

“…A part of children with AP is at risk of symptom persistence till adulthood [5,21,24,53]. Children with AP are found to score higher in questionnaires assessing psychopathological symptoms especially internalizing disturbances such as anxiety and other somatic complaints [14,17,52]. They also feature a high rate of psychiatric disorders such as anxiety disorders and depression [4,36].…”

Section: Introductionmentioning

confidence: 99%

“…Derived from good evidence in treating adults with long-standing IBS with hypnotherapy (HT) [16,18,58], this might also be a promising approach in handling FAP and IBS in childhood [47][48][49]. The most comprehensive study in HT treatment of FAP and IBS in children and adolescents (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years) by a Dutch workgroup [48,49] could demonstrate that HT was highly superior to standard medical care, even in a longterm follow-up. A study in the United States was able to show that self-administered audio-recorded HT for children and adolescents with FAP (6-15 years) was superior to a waiting list condition [47].…”

Section: Introductionmentioning

confidence: 99%

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Brief hypnotherapeutic–behavioral intervention for functional abdominal pain and irritable bowel syndrome in childhood: a randomized controlled trial

et al. 2013

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Functional abdominal pain and irritable bowel syndrome are two prevalent disorders in childhood which are associated with recurrent or chronic abdominal pain, disabilities in daily functioning, and reduced quality of life. This study aimed to evaluate a brief hypnotherapeuticbehavioral intervention program in a prospective randomized controlled design. Thirty-eight children, 6 to 12 years of age, and their parents were randomly assigned to a standardized hypnotherapeutic-behavioral treatment (n=20) or to a waiting list condition (n=18). Both groups were reassessed 3 months after beginning. Primary outcome variables were child-completed pain measures and pain-related disability. Secondary outcome variables were parent-completed measures of their children's pain and pain-related disability. Health-related quality of life from both perspectives also served as a secondary outcome. In the treatment group, 11 of 20 children (55.0 %) showed clinical remission (>80 % improvement), whereas only one child (5.6 %) in the waiting list condition was classified as responder. Children in the treatment group reported a significantly greater reduction of pain scores and pain-related disability than children of the waiting list condition. Parental ratings also showed a greater reduction of children's abdominal pain and pain-related disability. Health-related quality of life did not increase significantly. Conclusions: Hypnotherapeutic and behavioral interventions are effective in treating children with long-standing AP. Treatment success of this brief program should be further evaluated against active interventions with a longer follow-up.

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Burden of Anxiety Disorders in Pediatric Medical Settings

Ramsawh¹,

Chavira²,

Stein³

2010

Arch Pediatr Adolesc Med

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Anxiety and Somatic Complaints in Children with Recurrent Abdominal Pain and Anxiety Disorders

Abstract: RAP and anxiety are closely related. Further understanding between these disorders is essential to understanding the development and progression of RAP, and to inform the prevention and treatment of the disorder.

Cited by 128 publications

References 27 publications

Functional Abdominal Pain in Childhood and Long-term Vulnerability to Anxiety Disorders

Functional Abdominal Pain in Childhood and Long-term Vulnerability to Anxiety Disorders

Brief hypnotherapeutic–behavioral intervention for functional abdominal pain and irritable bowel syndrome in childhood: a randomized controlled trial

Burden of Anxiety Disorders in Pediatric Medical Settings

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