CLINICAL AND PSYCHOLOGICAL CHARACTERIZATI ON OF CHILDREN WITH RECURRENT ABDOMINAL-PAIN

There is ample empirical evidence supporting the view of emotional dis turbances in children with recurrent abdominal pain (RAP) as well as i n their parents. However, controlled studies have reported that such m anifestations can also be found in patients with other chronic ailment s. In order to characterize further the nature of emotional factors in RAP patients, we conducted a controlled psychological evaluation of 4 6 consecutive new patients with RAP, aged 7-17 years, (group A) by mea ns of structured interviews and questionnaires. Two control groups of pediatric patients with chronic illnesses were also assessed using the same methodology. Group B consisted of 22 individuals with chronic ab dominal pain and endoscopy-proven peptic ulcer or duodenitis, and grou p C consisted of 24 individuals with chronic, stable, non-gastroentero logical diseases (e.g., diabetes mellitus or physical handicaps). Pare nts were evaluated for depressive symptoms. One-way analysis of varian ce and contingency tables were used for statistical comparisons. There was a higher proportion of female patients in group A than in group B (70 vs 41%; p<0.05). There were significantly more patients in group A than in group B that reported that their abdominal pain: a) never ap peared during sleep, b) began soon after the patient's arousal in the morning, c) remitted completely or was alleviated during school holida ys, d) its remission was usually spontaneous during the day and e) did never interfere with recreational activities. Emotional problems were significantly more prevalent in patients in group B than in those in group A (p = 0.016). Past diagnosis of depression was more frequent in group A mothers (40%) than in those group B (27%), or group C (17%), but these differences did not attain statistical significance. These r esults suggest that psychological profiles of children suffering from certain chronic conditions (and those of their parents) may be more co mplex and particular than hitherto recognized. The role of type II err or and of some potential socioeconomic and demographic confounding fac tors must be considered when analyzing the validity of these data.