Functional gastrointestinal diseases and psychological maladjustment, personality traits and quality of life

Abstract

BackgroundChronic abdominal pain is a common worldwide problem and known to be associated with psychological problems. This study evaluated the association between abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs), psychological maladjustment and personality traits in adolescents.MethodsAdolescents aged 13–18 years were recruited from 5 randomly selected schools in Ampara district of Sri Lanka. AP-FGIDs were diagnosed using Rome III criteria. Translated and validated Rome III questionnaire (Child report form), personality questionnaire (PAQ) and PedsQL (Pediatric Quality of Life) inventory were used in data collection. Written consent was obtained from a parent and assent was obtained from every child recruited. The questionnaire was distributed in an examination setting to ensure confidentiality and privacy. Research assistants were present during data collection to assist on any necessary clarifications.ResultsA total of 1697 subjects were recruited [males 779 (45.9%), mean age 15.1 years, SD 1.6 years]. AP-FGIDs were present in 202 (11.9%). Those with AP-FGIDs had significantly higher mean scores for all personality traits (hostility and aggression, negative self-esteem, emotional unresponsiveness, emotional instability and negative world view), except dependency. Affected children had lower scores for all 4 domains of HRQoL (physical, emotional, social and school functioning), compared to controls (p < 0.05). When the cut off value for Sri Lankan children (89) was used, 66.3% with AP-FGIDs and 48.2% controls had PAQ scores within that of psychological maladjustment (p < 0.001). When the international normative value of 105 was used, these percentages were 27.2% and 14.2% respectively (p < 0.0001). The scores obtained for PAQ negatively correlated with scores obtained for HRQoL (r = − 0.52, p < 0.0001). One hundred and seventeen adolescents with AP-FGIDs (57.9%) had sought healthcare for their symptoms. Healthcare consulters had higher PAQ and lower HRQoL scores (p < 0.05).ConclusionsAdolescents with AP-FGIDs have more psychological maladjustment and abnormal personality traits than healthy controls. Affected adolescents with higher psychological maladjustments have lower HRQoL. Greater psychological maladjustment and lower HRQoL are associated with healthcare seeking behaviour in adolescents with AP-FGIDs.

Nausea exacerbates symptom burden, quality of life, and functioning in adolescents with functional abdominal pain disorders

“…A comprehensive study by Walker et al described distinct psychological profiles of patients with functional abdominal pain, with a subset showing dysfunctional coping skills, higher negative affect, more catastrophizing behaviors, and reduced functioning . Another recent large study of adolescents with FAPDs documented lower health‐related quality of life in those patients with higher psychological maladjustment and health care seeking behaviors . Interestingly, our study did not find a higher trait or state anxiety in the subjects who reported chronic nausea vs no nausea.…”

Exploration and Practice of Maker Education Mode in Innovation and Entrepreneurship Education

“…Psychological quality is the representation of a stable psychological feature, an organic whole formed of cognition, emotion, will, and personality, which guides people's psychology and practical activities (Ranasinghe et al, 2018;Dougherty et al, 2019). Based on this, in the innovation and entrepreneurship activities for college students, entrepreneurial psychological quality is a comprehensive psychological quality formed and developed by individuals under the comprehensive interaction of education and environment.…”

Irritable bowel syndrome in children: Current knowledge, challenges and opportunities

“…Several psychological factors have been recognized as risk factors for development of IBS. They include psychological stress[ 11 , 44 , 45 ], excess worry[ 45 ], anxiety[ 1 , 41 ], depression[ 1 ], physical, emotional and sexual abuse[ 46 ] and abnormal personality traits[ 1 , 10 ]. Furthermore, the adult studies have shown that these exposures lead to persistence of symptoms of FAPDs such as IBS into adulthood[ 47 ].…”

“…Presence of hard stools > 25% of the time with loose watery stools < 25% of the time helps to diagnose IBS-C whereas the opposite denotes the diagnosis of IBS-D. Alteration of stool pattern between diarrhea and constipation over a period of time suggests IBS-M whereas when the stool pattern is not like any of these, it leads to the diagnosis of IBS-U[ 18 ] (Table 1 ). In addition, children with IBS are suffering from a large number of somatic symptoms and psychological problems including maladjustment, depression and anxiety[ 10 , 46 ]. Eliciting these in the history would also help in the diagnosis and long term management of these children.…”

“…Irritable bowel syndrome (IBS) is a common pediatric functional gastrointestinal disorder (FGID)[ 1 - 10 ] with severe disabling upper and lower gastrointestinal symptoms[ 11 ] and extra-intestinal symptoms[ 1 , 11 ]. It has a significant impact on daily activities[ 2 , 11 , 12 ], education[ 11 - 13 ] and health related quality of life[ 9 , 10 , 13 , 14 ] of affected children. The healthcare consultation rate is high in affected children[ 1 , 9 , 15 ] and it leads to a significant annual healthcare cost[ 15 - 17 ].…”