Functional Abdominal Pain in Childhood and Long-term Vulnerability to Anxiety Disorders
Open accessAbstract
BACKGROUND: Cross-sectional studies link functional abdominal pain (FAP) to anxiety and depression in childhood, but no prospective study has evaluated psychiatric status in adulthood or its relation to pain persistence. METHODS: Pediatric patients with FAP (n = 332) and control subjects (n = 147) were tracked prospectively and evaluated for psychiatric disorders and functional gastrointestinal disorders (FGIDs) at follow-up in adolescence and young adulthood (mean age = 20.01 years). Participants were classified according to presence (FGID-POS) or absence (FGID-NEG) of FGIDs at follow-up. RESULTS: Lifetime and current risk of anxiety disorders was higher in FAP than controls (lifetime: 51% vs 20%; current: 30% vs 12%). Controlling for gender and age, the odds ratio was 4.9 (confidence interval = 2.83–7.43) for lifetime anxiety disorder and 3.57 (confidence interval = 2.00–6.36) for current anxiety disorder at follow-up for FAP versus controls. Lifetime risk of depressive disorder was significantly higher in FAP versus controls (40% vs. 16%); current risk did not differ. In most cases, initial onset of anxiety disorders was before pediatric FAP evaluation; onset of depressive disorders was subsequent to FAP evaluation. Within the FAP group, risk of current anxiety disorders at follow-up was significantly higher for FGID-POS versus FGID-NEG (40% vs 24%), and both were higher than controls (12%); current depressive disorders did not differ across FGID-POS, FGID-NEG, and controls. CONCLUSIONS: Patients with FAP carry long-term vulnerability to anxiety that begins in childhood and persists into late adolescence and early adulthood, even if abdominal pain resolves.
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Studies show elevated anxiety levels in pediatric populations diagnosed with diabetes, functional abdominal pain, coronary heart disease, and asthma.
“More specifically, studies show elevated anxiety levels in pediatric populations diagnosed with diabetes (Ducat et al., 2014), functional abdominal pain (Shelby et al., 2013), coronary heart disease (Oliver et al., 2020), and asthma (Pateraki et al., 2018).”
From Intolerance of Uncertainty and Health-Related Anxiety in Youth amid the COVID-19 Pandemic: Understanding and Weathering the Continuing Storm (2022) · cites this paper as Shelby et al., 2013
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- Authors
- Shelby, G. D., Shirkey, K. C., Sherman, A. L., Beck, J. E., Haman, K., Shears, A. R., Horst, S. N., Smith, C. A., Garber, J., & Walker, L. S.
- Affiliations
- Vanderbilt University (US)
- Departments of Pediatrics,
- Medicine, and
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2013-09-01
- Volume
- 132
- Issue
- 3
- Pages
- 475-482
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3876748
- OpenAlex
- W2136729608
- Cited by
- 272
- References
- 53
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 25 · 2023: 20 · 2022: 26 · 2021: 33 · 2020: 24 · 2019: 28 · 2018: 12 · 2017: 17 · 2016: 20 · 2015: 19 · 2014: 14 · 2013: 3
- FWCI
- 17.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (T32MH018921)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK058404)
- National Center for Research Resources (UL1RR024975)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD015052, R01HD023264)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- functional abdominal pain, anxiety disorders, depressive disorders, functional gastrointestinal disorders, childhood, pain persistence
- MeSH terms
- Adolescent, Anxiety Disorders, Mental Disorders, Child, Chronic Disease, Depressive Disorder, Female, Follow-Up Studies, Gastrointestinal Diseases, Humans, Interview, Psychological, Male, Prospective Studies, Recurrence, Risk, Somatoform Disorders, Tennessee, Abdominal Pain
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