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John V. Campo, MD; Jeff Bridge, PhD; Amanda Lucas, MEd; Steven Savorelli; Lynn Walker, PhD; Carlo Di Lorenzo, MD; Satish Iyengar, PhD; David A. Brent, MD

Arch Pediatr Adolesc Med. 2007;161(2):131-137.

Objective  To determine if mothers of youth with functional abdominal pain (FAP) experience more anxiety, depressive, and somatic symptoms and disorders than mothers of unaffected children.

Design  Case-control study.

Setting  Four primary care pediatric practices in western Pennsylvania.

Participants  Mothers of 8- to 15-year-old children and adolescents presenting with FAP (59 cases) or for routine care in the absence of recurrent pain (76 controls).

Outcome Measures  Questionnaires and blinded interviews assessing anxiety, depressive, and somatic symptoms and disorders; quality of life; and service use.

Results  On univariate analyses, mothers of FAP cases were significantly more likely than mothers of controls to have a lifetime history of irritable bowel syndrome (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.5-10.3), migraine (OR, 2.4; 95% CI, 1.1-5.3), and anxiety (OR, 4.8; 95% CI, 2.2-10.6), depressive (OR, 4.9; 95% CI, 2.2-11.0), and somatoform (OR, 16.1; 95% CI, 2.0-129.8) disorders than mothers of controls, and current anxiety, depressive, and somatic symptoms, poorer overall quality of life, and greater use of ambulatory health, but not mental health, services. Multivariate logistic regression found pediatric FAP to be most closely associated with maternal history of anxiety and depression (adjusted OR, 6.1; 95% CI, 1.8-20.8).

Conclusions  Functional abdominal pain may be better conceptualized as a disorder of emotion than a narrowly defined disorder of gastrointestinal function. Low rates of mental health service use by mothers of youth with FAP suggest that family health and illness attitudes deserve study.

Author Affiliations: Departments of Psychiatry (Drs Campo and Ms Lucas) and Pediatrics (Drs Bridge and Di Lorenzo), Columbus Children's Hospital, The Ohio State University, Columbus; Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pa (Mr Savorelli and Drs Iyengar and Brent); and Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn (Dr Walker).