Recurrent abdominal pain, anxiety, and depression in primary care
Recurrent abdominal pain, anxiety, and depression in primary care
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DOI：
10.1542/peds.113.4.817
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发表时间：
2004-04-01
期刊：
影响因子：
8
通讯作者：
Brent, DA
中科院分区：
文献类型：
--
作者：
Campo, JV;Bridge, J;Brent, DA
客观的。患有功能性复发性腹痛 (RAP) 的儿童和青少年精神疾病的患病率尚不清楚。我们的目的是确定 RAP 是否与儿科初级保健中的精神症状和疾病、焦虑气质和功能障碍相关。方法。通过儿科初级保健办公室候诊室的筛查程序，对患有 RAP（N = 42）或接受常规护理（N = 38）的 8 至 15 岁（含）儿童和青少年进行病例对照研究。结果测量是通过标准化精神病学访谈得出的精神病学诊断，该访谈不考虑受试者状态以及自我、父母和临床医生对儿童精神症状、气质特征和功能状态的评级。结果。 RAP 患者被诊断为精神疾病的可能性明显更高，其中 33 名患者 (79%) 患有绝对焦虑症，18 名患者 (43%) 患有抑郁症，并且与对照受试者相比，他们的焦虑和抑郁症状、气质伤害回避和功能障碍水平更高。在伴有焦虑的患者中，焦虑障碍（平均发病年龄：6.25 [标准差：2.17] 岁）明显更可能先于 RAP（平均发病年龄：9.17 [标准差：2.75] 岁）。结论。在初级保健中出现 RAP 的青少年应该仔细评估其焦虑和抑郁障碍。未来的研究应该检查已被证明对儿童焦虑和/或抑郁症有效的治疗方法，作为 RAP 的潜在干预措施。需要进行纵向、家庭和心理生物学研究来阐明观察到的 RAP、焦虑和抑郁之间关联的本质。
Objective. The prevalence of psychiatric disorder in children and adolescents with functional recurrent abdominal pain ( RAP) is unknown. Our aim was to determine whether RAP is associated with psychiatric symptoms and disorders, anxious temperament, and functional impairment in pediatric primary care.Methods. Children and adolescents who were 8 to 15 years of age, inclusive, and presented with RAP (N = 42) or for routine care in the absence of recurrent pain ( N = 38) were identified by a screening procedure in pediatric primary care office waiting rooms and recruited to participate in a case-control study. Outcome measures were psychiatric diagnoses generated by standardized psychiatric interview administered blind to subject status and self, parent, and clinician ratings of child psychiatric symptoms, temperamental traits, and functional status.Results. RAP patients were significantly more likely to receive a diagnosis of a psychiatric disorder, with a categorical anxiety disorder in 33 (79%) and a depressive disorder in 18 patients (43%), and higher levels of anxiety and depressive symptoms, temperamental harm avoidance, and functional impairment than control subjects. Anxiety disorders ( mean age of onset: 6.25 [ standard deviation: 2.17] years) were significantly more likely to precede RAP ( mean age of onset: 9.17 [ standard deviation: 2.75] years) in patients with associated anxiety.Conclusions. Youths who present with RAP in primary care deserve careful assessment for anxiety and depressive disorders. Future studies should examine treatments that are proved to be efficacious for pediatric anxiety and/or depressive disorders as potential interventions for RAP. Longitudinal, family, and psychobiological studies are needed to illuminate the nature of observed associations among RAP, anxiety, and depression.