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

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. Pediatric patients with FAP (n = 332) and control subjects (n = 147) were tracked prospecti...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2013-09, Vol.132 (3), p.475-482
Main Authors: SHELBY, Grace D, SHIRKEY, Kezia C, SHERMAN, Amanda L, BECK, Joy E, HAMAN, Kirsten, SHEARS, Angela R, HORST, Sara N, SMITH, Craig A, GARBER, Judy, WALKER, Lynn S
Format: Article
Language:English
Subjects:
Abdominal Pain - epidemiology
Abdominal Pain - psychology
Adolescent
Adult and adolescent clinical studies
Anxiety Disorders - diagnosis
Anxiety Disorders - epidemiology
Anxiety Disorders - psychology
Anxiety in children
Biological and medical sciences
Child
Childhood anxiety
Childhood depression
Chronic Disease
Demographic aspects
Depression
Depression in children
Depressive Disorder - diagnosis
Depressive Disorder - epidemiology
Depressive Disorder - psychology
Female
Follow-Up Studies
Gastrointestinal diseases
Gastrointestinal Diseases - diagnosis
Gastrointestinal Diseases - psychology
General aspects
Humans
Interview, Psychological
Male
Medical sciences
Mental Disorders - diagnosis
Mental Disorders - epidemiology
Mental Disorders - psychology
Mood disorders
Prospective Studies
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Recurrence
Risk
Somatoform Disorders - diagnosis
Somatoform Disorders - epidemiology
Somatoform Disorders - psychology
Tennessee
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Summary: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. 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 follow-up 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. 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. Patients with FAP carry long-term vulnerability to anxiety that begins in childhood and persists into late adolescence and early adulthood, even if abdominal pain resolves.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2012-2191