Behavioral functioning and treatment adherence in pediatric eosinophilic gastrointestinal disorders

Area of Science:

• Gastroenterology
• Pediatrics
• Psychology

Background:

• Eosinophilic gastrointestinal disorders (EGID) encompass conditions like eosinophilic esophagitis and gastroenteritis.
• Treatment adherence is crucial for managing EGID but can be challenging in pediatric populations.

Purpose of the Study:

• To identify behavioral predictors of treatment adherence in children and adolescents diagnosed with EGID.
• To investigate the association between internalizing and externalizing symptoms and adherence to medical recommendations.

Main Methods:

• A cohort of 96 pediatric patients (2.5-18 years) with EGID and their caregivers were studied.
• Maternal and paternal reports of child/adolescent internalizing (anxiety, depression) and externalizing (aggression, anger) symptoms were assessed using the BASC-2.
• Adherence was classified as adherent or non-adherent based on an 80% cut point from a multi-informant approach.

Main Results:

• Sociodemographic factors did not differentiate between adherent and non-adherent patients.
• Maternal reports of internalizing symptoms, specifically depression, significantly correlated with non-adherence (p < 0.001).
• Depressed patients were over 7 times more likely to be non-adherent compared to non-depressed patients (OR = 7.27, p < 0.05). Paternal reports showed no association.

Conclusions:

• Maternal-reported internalizing symptoms, particularly depression, are significant predictors of non-adherence in pediatric EGID patients.
• These behavioral symptoms represent potential risk factors for non-adherence and warrant clinical consideration.
• Routine screening for depression in the clinical care of EGID patients is recommended to address adherence issues.