OBJECTIVES: Abdominal pain is a frequent childhood complaint, comprising 2% to 4% of all reasons for pediatric office visits. Patients referred for evaluation of chronic abdominal pain (CAP) frequently present with comorbid nonspecific somatic symptoms that may complicate the medical evaluation and lead to unnecessary diagnostic tests and procedures. We tested the hypothesis that multiple nongastrointestinal (GI) symptoms in children presenting with CAP is a marker for clinically significant levels of depressive symptoms. METHODS: Participants were 400 consecutive new patients (ages 8-17 years; 63% female) referred to the pediatric gastroenterology clinic for evaluation of abdominal pain of > 3 months' duration. Patients reported how frequently they experienced 7 non-GI symptoms. Patients were screened for depression with the Children's Depression Inventory. RESULTS: On the basis of their Children's Depression Inventory scores, 58 (15%) patients had a positive screen for clinically significant depressive symptoms. Patients with a positive versus negative depression screen did not differ by sex, pain duration or laboratory evidence of organic disease. Patient report of > or = 3 non-GI symptoms maximized sensitivity (71%) and specificity (75%) in prediction of depression screening results. With each addition of a non-GI symptom, the odds of a positive screen for depression doubled. CONCLUSIONS: For patients with and without organic disease findings associated with CAP, the presence of > or = 3 non-GI symptoms should signal the practitioner to evaluate for depression and may be used as an indicator of the likelihood of depression in the absence of specific inquiry into emotional symptoms.
OBJECTIVES:Abdominal pain is a frequent childhood complaint, comprising 2% to 4% of all reasons for pediatric office visits. Patients referred for evaluation of chronic abdominal pain (CAP) frequently present with comorbid nonspecific somatic symptoms that may complicate the medical evaluation and lead to unnecessary diagnostic tests and procedures. We tested the hypothesis that multiple nongastrointestinal (GI) symptoms in children presenting with CAP is a marker for clinically significant levels of depressive symptoms. METHODS:Participants were 400 consecutive new patients (ages 8-17 years; 63% female) referred to the pediatric gastroenterology clinic for evaluation of abdominal pain of > 3 months' duration. Patients reported how frequently they experienced 7 non-GI symptoms. Patients were screened for depression with the Children's Depression Inventory. RESULTS: On the basis of their Children's Depression Inventory scores, 58 (15%) patients had a positive screen for clinically significant depressive symptoms. Patients with a positive versus negative depression screen did not differ by sex, pain duration or laboratory evidence of organic disease. Patient report of > or = 3 non-GI symptoms maximized sensitivity (71%) and specificity (75%) in prediction of depression screening results. With each addition of a non-GI symptom, the odds of a positive screen for depression doubled. CONCLUSIONS: For patients with and without organic disease findings associated with CAP, the presence of > or = 3 non-GI symptoms should signal the practitioner to evaluate for depression and may be used as an indicator of the likelihood of depression in the absence of specific inquiry into emotional symptoms.
Authors: B Starfield; R A Hoekelman; M McCormick; P Benson; R C Mendenhall; C Moynihan; S Radecki Journal: Pediatrics Date: 1984-12 Impact factor: 7.124
Authors: M Liakopoulou-Kairis; T Alifieraki; D Protagora; T Korpa; K Kondyli; E Dimosthenous; G Christopoulos; T Kovanis Journal: Eur Child Adolesc Psychiatry Date: 2002-06 Impact factor: 4.785
Authors: John V Campo; Jeff Bridge; Mary Ehmann; Sarah Altman; Amanda Lucas; Boris Birmaher; Carlo Di Lorenzo; Satish Iyengar; David A Brent Journal: Pediatrics Date: 2004-04 Impact factor: 7.124
Authors: Martina Puzanovova; Patrick G Arbogast; Craig A Smith; Julia Anderson; André Diedrich; Lynn S Walker Journal: J Psychosom Res Date: 2009-04-15 Impact factor: 3.006
Authors: Sara Horst; Grace Shelby; Julia Anderson; Sari Acra; D Brent Polk; Benjamin R Saville; Judy Garber; Lynn S Walker Journal: Clin Gastroenterol Hepatol Date: 2014-04-13 Impact factor: 11.382