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PEDIATRICS Vol. 108 No. 1 July 2001, p. e1

ELECTRONIC ARTICLE:
Adult Outcomes of Pediatric Recurrent Abdominal Pain: Do They Just Grow Out of It?

Received Sep 18, 2000; accepted Feb 8, 2000.

John V. Campo, Carlo Di Lorenzo, Laurel Chiappetta, Jeff Bridge, D. Kathleen Colborn, J. Carlton Gartner Jr, Paul Gaffney, Samuel Kocoshis, and David Brent

From the University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, and Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania.

Objective.  To determine whether medically unexplained recurrent abdominal pain (RAP) in childhood predicts abdominal pain, irritable bowel syndrome (IBS), other somatic complaints, and psychiatric symptoms and disorders in young adulthood.

Methods.  A sample of 28 young adults evaluated for RAP between the ages of 6 and 17 years were compared with 28 individually matched former childhood participants in a study of tonsillectomy and adenoidectomy. RAP caseness was established by structured retrospective chart review requiring agreement by 2 independent reviewers. Standardized assessments of abdominal pain, IBS, other somatic symptoms, psychopathology, perceived health, and history of maltreatment were performed an average of 11.1 years after the index visit.

Results.  Former RAP patients were significantly more likely than controls to endorse anxiety symptoms and disorders, hypochondriacal beliefs, greater perceived susceptibility to physical impairment, poorer social functioning, current treatment with psychoactive medication, and generalized anxiety in first degree relatives. There were trends suggesting associations between childhood RAP and lifetime psychiatric disorder, depression, migraine, and family history of depression, but group differences on abdominal pain, IBS, other somatic symptoms, and history of maltreatment were not statistically significant.

Conclusions.  There is a strong and relatively specific association between childhood RAP and anxiety in young adulthood. Affected children may be at special risk to perceive physical symptoms as threatening, and should be evaluated for psychiatric disorder on initial presentation.  Key words:  abdominal pain, pain, anxiety, depression, colonic diseases, functional.




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P3Rs:

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What is an adequate work-up before referral?
Harold Vann
Pediatrics Online, 2 Jul 2001 [Full text]
Response to Dr. Vann
John V Campo
Pediatrics Online, 2 Jul 2001 [Full text]