Department of Child and Adolescent Psychiatry, Innlandet Hospital Trust, Gjovik, Norway.
Acta Paediatr. 2011 Nov;100(11):1461-7. doi: 10.1111/j.1651-2227.2011.02349.x. Epub 2011 Jun 11.
First, to what extent do general paediatric outpatients with functional abdominal pain experience other somatic and mental health symptoms compared with children in a population-based sample? Second, to what extent are such symptoms in both patients and their mothers associated with persistent child abdominal pain and functional disability?
Ninety-four referred patients [mean age (SD) 11.1 (1.9) years, 62% girls] were assessed by questionnaires and a paediatric consultation at baseline and at follow-up after 6-9 months (94% follow-up participation). At baseline, somatic and mental health symptoms in the patients were compared with a population-based sample of 14,000 school children. Outcome at follow-up was patient self-reported abdominal pain and disability. Prognostic factors explored included patient and maternal somatic and mental health symptoms.
The patients experienced significantly more somatic [e.g. headache (OR: 9.2; 95% CI: 5.9-14.6)] and emotional symptoms than the school children. Patient's older age and peer problems at baseline were significantly associated with more abdominal pain at follow-up, whereas patient's older age, emotional symptoms, prosocial behaviour and maternal somatic symptoms were associated with disability.
Our results highlight the importance of focusing wider than just the patient's symptoms of abdominal pain in clinical practice and research.
首先,与基于人群的样本相比,患有功能性腹痛的普通儿科门诊患者在多大程度上经历其他躯体和心理健康症状?其次,患者及其母亲的这些症状在多大程度上与持续性儿童腹痛和功能性残疾有关?
94 名就诊患者[平均年龄(SD)11.1(1.9)岁,62%为女孩]在基线和 6-9 个月后的随访时通过问卷和儿科会诊进行评估(94%的随访参与率)。在基线时,患者的躯体和心理健康症状与 14000 名学龄儿童的基于人群的样本进行了比较。随访时的结果是患者自我报告的腹痛和残疾。探索的预后因素包括患者和母亲的躯体和心理健康症状。
与学龄儿童相比,患者经历了更多的躯体症状[例如头痛(OR:9.2;95%CI:5.9-14.6)]和情绪症状。患者的年龄较大和基线时的同伴问题与随访时的更多腹痛显著相关,而患者的年龄较大、情绪症状、亲社会行为和母亲的躯体症状与残疾有关。
我们的研究结果强调了在临床实践和研究中关注患者腹痛症状以外的症状的重要性。