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The course of mental health problems in children presenting with abdominal pain in general practice
Marieke J Gieteling1, Yvonne Lisman-van Leeuwen, Jan Passchier
1Department of General Practice, Erasmus MC–University Medical Center Rotterdam, the Netherlands.
Insights
Mental health issues like anxiety and depression persist in about one-third of children with abdominal pain seen in primary care over a year. Abdominal pain characteristics did not predict these mental health problems, highlighting the need for ongoing monitoring.
Area of Science:
- Pediatric Health
- Mental Health Research
- General Practice
Background:
- Abdominal pain is a common presenting complaint in children attending general practice.
- The co-occurrence and persistence of mental health problems in these children require further investigation.
- Understanding predictors for mental health issues is crucial for timely intervention.
Purpose of the Study:
- To examine the trajectory of mental health problems in children with abdominal pain in general practice.
- To determine if abdominal pain characteristics predict mental health issues at 12-month follow-up.
Main Methods:
- Prospective cohort study conducted in 53 general practices in the Netherlands (2004-2006).
- Included 281 children aged 4-17 years presenting with abdominal pain.
- Assessed depressive problems, anxiety problems, and non-specific somatic symptoms at 12-month follow-up.
Main Results:
- Persistent depressive problems observed in 32.9% and anxiety problems in 30.2% of children.
- Multiple non-specific somatic symptoms were present in 44.1% of children at follow-up.
- Abdominal pain characteristics did not predict anxiety or depressive problems; however, more frequent moderate to severe pain predicted somatic symptoms.
Conclusions:
- Approximately one-third of children with abdominal pain experience persistent anxiety and depressive problems one year later.
- Abdominal pain features during follow-up do not reliably predict future anxiety or depressive issues.
- Continuous monitoring of children presenting with abdominal pain in primary care is recommended.
Objective:
To investigate the course of mental health problems in children presenting to general practice with abdominal pain and to evaluate the extent to which abdominal pain characteristics during follow-up predict the presence of mental health problems at 12 months' follow-up.
Design:
A prospective cohort study with one-year follow-up.
Setting:
53 general practices in the Netherlands, between May 2004 and March 2006.
Subjects:
281 children aged 4-17 years.
Main Outcome Measures:
The presence of a depressive problem, an anxiety problem, and multiple non-specific somatic symptoms at follow-up and odds ratios of duration, frequency, and severity of abdominal pain with these mental health problems at follow-up.
Results:
A depressive problem persisted in 24/74 children (32.9%; 95% CI 22.3-44.9%), an anxiety problem in 13/43 (30.2%; 95% CI 17.2-46.1%) and the presence of multiple non-specific somatic symptoms in 75/170 children (44.1%; 95% CI 36.7-51.6%). None of the abdominal pain characteristics predicted a depressive or an anxiety problem at 12 months' follow-up. More moments of moderate to severe abdominal pain predicted the presence of multiple non-specific somatic symptoms at follow-up.
Conclusions:
In one-third of the children presenting to general practice for abdominal pain, anxiety and depressive problems persist during one year of follow-up. Characteristics of the abdominal pain during the follow-up period do not predict anxiety or depressive problems after one-year follow-up. We recommend following over time children seen in primary care with abdominal pain.
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