Relationship between the decision to take a child to the clinic for abdominal pain and maternal psychological distress.

BACKGROUND

Among adults with functional gastrointestinal disorders, psychological distress influences who consults a physician, but little is known about predictors of consultation when the patient is a child.

OBJECTIVE

To determine the relative contributions of psychological symptoms of the mother, psychological symptoms of the child, severity of child abdominal pain, and family stress to consultation.

DESIGN

Observational study.

SETTING

Health maintenance organization.

PARTICIPANTS

Two hundred seventy-five mothers of 334 children who had abdominal pain in the past 2 weeks, as per child self-report.

MAIN OUTCOME MEASURES

Mothers completed questionnaires about themselves (Symptom Checklist 90-Revised) and their children (school absences, medication use, and the Child Behavior Checklist). Children completed the Pain Beliefs Questionnaire to assess perceived pain severity.

RESULTS

Thirty-nine children had been taken to the clinic for abdominal pain symptoms at least once in the past 3 months (consulters), whereas 295 were nonconsulters. Logistic regression analyses revealed that both the child's self-report of perceived pain severity (P<.001) and maternal psychological symptoms (P = .006) predicted consultation. Although children who visited physicians had significantly more psychological symptoms, this was not a significant predictor of consultation after adjusting for maternal psychological symptoms. Family stress did not predict consultation.

CONCLUSION

The decision to take a child to the clinic for abdominal pain is best predicted by maternal psychological distress and the child's perceived pain severity.