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儿科慢性腹痛队列研究 20 年结果:成年早期健康状况和后代的身体与行为健康。

Twenty-year Outcomes of a Pediatric Chronic Abdominal Pain Cohort: Early Adulthood Health Status and Offspring Physical and Behavioral Health.

机构信息

Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.

Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee.

出版信息

J Pain. 2023 Jan;24(1):145-156. doi: 10.1016/j.jpain.2022.09.007. Epub 2022 Sep 17.

Abstract

Chronic abdominal pain (CAP) represents a common pediatric primary pain disorder that can have long-term effects on physical and mental health into adulthood. Pediatric CAP and Control cohorts recruited in childhood (∼11 years old, T1) and then assessed in emerging adulthood (∼20 years old, T2) were evaluated again for health outcomes in early adulthood (∼30 years old, T3) for the current study. Further, the study evaluated the mental and physical health of offspring of participants who had become parents. Participants who agreed to enroll at T3 (CAP: n = 90, Control: n = 55) completed measures regarding current health, health-related quality of life (HRQoL), and their child's health when applicable. Results indicated close to 20% of the CAP cohort reported recurrent CAP across all 3 timepoints. Participants with current CAP reported poorer HRQoL compared to participants with remitted CAP who reported poorer HRQoL compared to Control participants. The CAP cohort reported higher health-related anxiety compared to the Control cohort regardless of current pain status. CAP compared to Control participants reported greater emotional problems and fewer conduct problems in their children. Longitudinal studies are needed to assess the developmental course of pediatric chronic pain and intergenerational pathways of risk and resilience. Perspective: This article evaluates patterns of chronic abdominal pain from childhood into early adulthood. Patients with pediatric chronic abdominal pain continue to present with health-related anxiety in adulthood and report greater emotional problems in offspring.

摘要

慢性腹痛 (CAP) 是一种常见的儿科原发性疼痛障碍,会对儿童期至成年期的身心健康产生长期影响。本研究再次评估了在儿童期(约 11 岁,T1)招募、随后在成年早期(约 20 岁,T2)进行评估的儿科 CAP 和对照组队列在成年早期(约 30 岁,T3)的健康结果。此外,该研究还评估了成为父母的参与者的后代的身心健康。同意在 T3 参与研究的参与者(CAP:n=90,对照:n=55)完成了关于当前健康状况、与健康相关的生活质量(HRQoL)以及其子女健康状况的评估。结果表明,近 20%的 CAP 队列在所有 3 个时间点均报告有复发性 CAP。与 CAP 缓解者相比,当前 CAP 患者的 HRQoL 更差,而 CAP 缓解者的 HRQoL 又比对照组参与者差。无论当前疼痛状况如何,CAP 队列的参与者报告的健康相关焦虑都高于对照组。与对照组参与者相比,CAP 队列的参与者报告其子女的情绪问题更多,行为问题更少。需要进行纵向研究以评估儿科慢性疼痛的发展过程和风险与复原力的代际途径。观点:本文评估了儿童期至成年早期慢性腹痛的模式。患有儿科慢性腹痛的患者在成年期仍会出现与健康相关的焦虑,并报告其子女有更多的情绪问题。

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