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Recurrent Abdominal Pain, Anxiety and Depression in Primary Care.Campo JV, Bridge J, Ehmann m et al. Pediatrics 2004;113;817-824
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.
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.
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