Well-adjusted children: An alternate view of children with inflammatory bowel disease and functional gastrointestinal complaints

Previous studies have suggested impaired psychosocial adjustment in childre n and adolescents with inflammatory bowel disease (IBD). We examined 62 sub jects referred to a regional Pediatric Gastroenterology Clinic with IBD or functional gastrointestinal (FGI) complaints. Characteristics of the clinic include a unified team approach, regularly scheduled appointments at 3-mon th intervals, proactive medical care emphasizing maintenance of full functi oning, and close medical-surgical interaction (joint clinics). A research a ssistant administered a questionnaire regarding children's perceptions of t heir illness, as well as the Child Depression Inventory (CDI), the Piers-Ha rris (PH) test of self-concept, and the Child Behaviour Checklist (CBCL). T he 36 children with LED (25 Crohn's disease, 11 ulcerative colitis, mean ag e 13.3 +/- 3.0 years) we compared with 26 patients with FGI complaints (16 recurrent abdominal pain, 10 functional megacolon, mean age 11.4 +/- 2.8 ye ars). The scores on the standardized tests were not clinically significant for either group. In comparison, however, children with IBD were less depre ssed and had fewer behaviour problems than the FGI group. Surprisingly, onl y 19% (7 of 36) of children with LED described their illness as a problem t o them, compared with 65% (17 of 26) of children with FGI symptoms. The lat ter children also considered themselves significantly sicker than did those with IBD. We conclude that normal psychosocial adjustment is possible in pediatric pa tients with LED. We speculate that this group benefitted from the professio nal supports that our clinic specifically provides to patients with LED. Th e FGI group may have suffered from a lack of such professional supports, as well as from the absence of a specific diagnosis.