1. Children with functional abdominal pain (FAP) had a significantly greater risk of clinical anxiety and depression than those without FAP.
2. Social anxiety disorder affected 25% of individuals with FAP.
Evidence Rating Level: 1 (Excellent)
Study Rundown: FAP has been associated with frequent school absences as well as a high incidence of anxiety and depression. However, it is unclear whether individuals with FAP that resolves have rates of anxiety and depression similar to those with no FAP history at all. Results from this study indicate that half of individuals with FAP met criteria for at least one lifetime anxiety disorder compared to only 20% of controls and the risk of a lifetime anxiety disorder was more than four times that of controls. Similarly, significantly more individuals with FAP met criteria for a lifetime depressive disorder and had a two times greater risk than controls. Social anxiety disorder was the most common anxiety disorder diagnosed among study participants, affecting 25% of FAP individuals during their lifetime. All patients were evaluated at a tertiary care center, which may limit generalization to primary care settings. Nonetheless, these data highlight the importance of a biopsychosocial approach to FAP care that includes screening and treatment of mental health problems.
In-Depth [prospective cohort study]: 491 individuals (391 with FAP and 186 controls) ages 8 to 17 participated in this study. A significantly greater proportion of the FAP group met criteria for ≥1 lifetime anxiety disorder compared to controls (51.2% vs. 20.4%) and individuals with FAP were at significantly greater risk of developing an anxiety disorder (OR: 4.59, p < .001). Also, a greater proportion of the FAP group met criteria for ≥1 current anxiety disorder at follow-up (30.4% vs 11.6%) and individuals with FAP were at significantly greater risk of having a current anxiety disorder (OR: 3.57, p < .001). Social anxiety was the most common lifetime anxiety disorder in the FAP group, affecting 25.9% of these individuals. Individuals with FAP were 5.84 times more likely to have a lifetime social anxiety disorder and 8.14 times more likely to have a current social anxiety disorder. A significantly greater proportion of FAP individuals met criteria for a lifetime depressive disorder compared to controls (40.1% vs 16.3%) and individuals with FAP were at significantly greater risk of having a lifetime depressive disorder (OR: 2.62, p < .001).
By Cordelia Y. Ross and Leah H. Carr
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