SPA Newsletter

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Recurrent Abdominal Pain, Anxiety and Depression in Primary Care.

Reviewed by: Thomas J. Mancuso, MD, FAAP

The authors of this paper sought to learn the prevalence of psychiatric disorders in children and adolescents with recurrent abdominal pain (RAP). Children eight to 15 years of age comprised the study population and they were recruited for this case-control study in the offices of a primary care setting. The psychiatric diagnoses were generated using an standard psychiatric interview with the interviewer blinded to the status of the patient. In report for the child, parents and clinicians were used. Patients with RAP were significantly more likely to have anxiety disorder (79%), depressive disorder (43%), higher levels of depressive and anxiety and depressive symptoms and functional impairment than control subjects. In patients with anxiety disorders, the appearance of the disorder was very likely to precede the development of RAP by several years.

Commentary

While RAP is clearly a primary care pediatrics problem, these children do come to require the care of an anesthesiologist. No one wants to miss serious medical pathology. This concern often leads to invasive diagnostic tests such as upper and lower endoscopies, various scans etc. and many of these require anesthesia, particularly give the high level of anxiety in these patients as documented above. I think it is important that we, as anesthesiologists, are sensitive to these anxious, frightened children when they are in our care.

Table of Contents

• President's Message
• Editor's Corner
• Bylaws Amended
• Genesis of a CPT Code
• Fellow's Corner
  Choosing a Career in Academic Pediatric Anesthesia


• SPA Elections
• Society for Pediatric Anesthesia Election Procedures
• Nominations


• Pediatric Anesthesiology 2004 Meeting Review
  Point Hilton Squaw Peak Resort - March 4-7, 2004
• Friday, March 5, 2004
• Saturday, March 6, 2004
• Sunday, March 7, 2004


• Reviews & Commentary
  • Perception of Child Vulnerability Among Mothers of Former Premature Infants
    Allen EC, Manuel JC, Legault C et al. Pediatrics 2004;113:267-273
  • Billing Practices, Ofri, D; Uninsured, Unwanted, Unworthy?
    Chesleigh, F. The Hastings Center Report Jan-Feb 2004
  • The Effect of Obesity, Gender and Ethnic Group of Left Ventricular Hypertrophy in Hypertensive Children: A Collaborative Study of the International Pediatric Hypertension Association
    Havevold C, Waller J, Daniels S et al. Pediatrics 2004;113:328-333
  • A Cautionary Tale About Supplemental Oxygen: The Albatross of Neonatal Medicine
    Silverman, WA Pediatrics 2004;113:394-396
  • EMLA Toxicity After Application for Allergy Skin Testing
    Parker JF, Vats A, Bauer G. Pediatrics 2004;113:410-411
  • Overweight, Ethnicity and the Prevalence of Hypertension in School-aged Children.
    Soro f JM, Lai DL, Turner J et al. Pediatrics 2004:113:475-482
  • Short term Use of umbilical Artery Catheters may not be Associated with Increased Risk For Thrombosis.
    Coleman MM, Spear ML, Finkelstein M et al. Pediatrics 2004;113:770-774
  • Recurrent Abdominal Pain, Anxiety and Depression in Primary Care.
    Campo JV, Bridge J, Ehmann m et al. Pediatrics 2004;113;817-824
  • The Ancillary-Care Responsibilities of Medical Researchers: An Ethical Framework for Thinking about the Clinical Care that Researchers owe their Subjects.
    Richardson, HS, Belsky L The Hastings Report Jan-Feb 2004;25-33


• Literature Reviews
  • The Effect of Small Dose Fentanyl on the Emergence Characteristics of Pediatric Patients After Sevoflurane Anesthesia Without Surgery
    Cravero J, Beach M, Thyr B, Whalen K. Anesthesia & Analgesia 2003;97:364-367.
  • Epidural analgesia in children. A Survey of Current Opinions and Practices amongst UK Paediatric Anaesthetists.
    Williams DG and Howard RF. Paediatric Anaesthesia 2003;13:769-776
  • Rapid emergence does not explain agitation following sevoflurane anaesthesia in infants and children: a comparison with propofol.
    Cohen IT, Finkel JC, Hannallah RS, Hummer KA, Patel KM. Paediatric Anaesthesia 2003;13:63-67

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