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

Overview

Journal Pediatrics

Specialty Pediatrics

Date 2013 Aug 14

PMID 23940244

Citations 97

Authors

Grace D Shelby

Kezia C Shirkey

Amanda L Sherman

Joy E Beck

Kirsten Haman

Angela R Shears

Sara N Horst

Craig A Smith

Judy Garber

Lynn S Walker

Affiliations

Soon will be listed here.

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 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.

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: 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.

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