Ramchandani Paul G, Fazel Mina, Stein Alan, Wiles Nicola, Hotopf Matthew
Department of Psychiatry, Oxford University, Oxford, UK.
Acta Paediatr. 2007 May;96(5):697-701. doi: 10.1111/j.1651-2227.2007.00291.x.
Recurrent abdominal pain is one of the commonest complaints of childhood, affecting approximately 10% of children at any one time. This study aims to describe the outcome of recurrent abdominal pain amongst 6-year-old children, and to identify risk factors (in both the children and their parents), which predict these outcomes.
7128 6-year-old children in the Avon Longitudinal Study of Parents and Children (ALSPAC) were followed up for 1 year. The principle outcomes were abdominal pain, number of days missed from school in the preceding year and psychiatric diagnoses.
Children with recurrent abdominal pain at age 6 years had higher rates of further abdominal pain [odds ratio 4.88 (95% CI: 4.01, 5.95)], school absence (10 or more days off school in a year) [OR 1.89 (1.53, 2.33)] and anxiety disorders [OR 2.36 (1.68, 3.32)] at age 7 years. Maternal anxiety was the most consistent predictor of subsequent adverse outcomes for these children.
Children with recurrent abdominal pain are at significant and continuing risk of adverse functioning. It is important for clinicians to take a whole family perspective, and particularly to consider parental anxiety, when a child with recurrent abdominal pain presents to them.
复发性腹痛是儿童最常见的主诉之一,在任何时候约有10%的儿童受其影响。本研究旨在描述6岁儿童复发性腹痛的结局,并确定(儿童及其父母双方的)危险因素,这些因素可预测这些结局。
对埃文亲子纵向研究(ALSPAC)中的7128名6岁儿童进行了为期1年的随访。主要结局包括腹痛、前一年缺课天数和精神疾病诊断。
6岁时有复发性腹痛的儿童在7岁时出现进一步腹痛的几率更高[比值比4.88(95%可信区间:4.01,5.95)]、缺课(一年中缺课10天或更多)[比值比1.89(1.53,2.33)]以及焦虑症[比值比2.36(1.68,3.32)]。母亲的焦虑是这些儿童后续不良结局最一致的预测因素。
患有复发性腹痛的儿童存在显著且持续的功能不良风险。当患有复发性腹痛的儿童就诊时,临床医生从整个家庭的角度考虑,尤其是考虑父母的焦虑,这很重要。