Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Sep;132(3):475-82.
doi: 10.1542/peds.2012-2191. Epub 2013 Aug 12.

Functional abdominal pain in childhood and long-term vulnerability to anxiety disorders

Grace D Shelby  1 , 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

Functional abdominal pain in childhood and long-term vulnerability to anxiety disorders

Grace D Shelby et al. Pediatrics. 2013 Sep.

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.

Keywords: anxiety; depression; functional gastrointestinal disorder; pediatric; prospective; psychiatric disorders.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Risk of lifetime and current psychiatric disorders for pediatric patients with FAP who met criteria for FGID at follow-up (FGID-POS), pediatric patients with FAP who did not meet criteria for FGID at follow-up (FGID-NEG), and control subjects. aP < .05; bP < .01; cP < .001.
See this image and copyright information in PMC

References

    1. Apley J, Hale B. Children with recurrent abdominal pain: how do they grow up? BMJ. 1973;3(5870):7–9 - PMC - PubMed
    1. Chitkara DK, Rawat DJ, Talley NJ. The epidemiology of childhood recurrent abdominal pain in Western countries: a systematic review. Am J Gastroenterol. 2005;100(8):1868–1875 - PubMed
    1. Saps M, Seshadri R, Sztainberg M, Schaffer G, Marshall BM, Di Lorenzo C. A prospective school-based study of abdominal pain and other common somatic complaints in children. J Pediatr. 2009;154(3):322–326 - PubMed
    1. Hyams JS, Burke G, Davis PM, Rzepski B, Andrulonis PA. Abdominal pain and irritable bowel syndrome in adolescents: a community-based study. J Pediatr. 1996;129(2):220–226 - PubMed
    1. Robinson JO, Alverez JH, Dodge JA. Life events and family history in children with recurrent abdominal pain. J Psychosom Res. 1990;34(2):171–181 - PubMed

MeSH terms