Hotopf, Matthew, “Why Do Children Have Chronic Abdominal Pain, and What Happens to Them When They Grow Up?” British Medical Journal, April 1998
Topic: “Why Do Children Have Chronic Abdominal Pain, and What Happens to Them When They Grow Up?”
Purpose: The purpose of this study was to evaluate the hypothesis that children who have persistent abdominal pain come from families with high rates of psychiatric disorder, neuroticism and physical illness. The study also analyzed whether these children will suffer from the previously mentioned illnesses in adulthood.
Subjects: The study the based on a sample stratified for social class of all singe legitimate births (3637) that occurred in England, Wales, and Scotland in one week of March in 1946. All children born to non-manual workers and agricultural workers were surveyed, while those born to other laborers were sampled in a ratio of 1:4. Controls were defined as survey members who participated in the same waves of data collection during early childhood, but whom either no abdominal pain was reported or it occurred only once or twice.
Information was based on hospital admissions of children who suffered from abdominal pain. Persistent abdominal pain was described as abdominal pain that was reported suggesting that the pain was chronic. Hospital records for these children were carefully reviewed by a pediatrician, and those with a defined organic cause of pain that was judged to have been present throughout childhood were excluded from the sample.
Parental illness was accessed when the survey members were aged 15. The mother was asked if she or her husband had suffered from illnesses such as asthma, cough, rheumatism in joints, anemia, heart trouble, kidney trouble, and other health complaints. School attendance records of the children were assessed twice during childhood. Teachers were asked to rate whether the child’s attendance was below average, or above average. This was done when the child was 13 years of age and again at 15 years of age.
The Printer personality inventory was used when the child was 13 years of age to determine the child’s personality and behavior in terms of neuroticism and extroversion. Again, the child’s teacher was asked to evaluate the child. This time the teacher rated the child in terms of: lying, disobedience, being a disciplinary problem, restlessness, quality of work, and energy level. The standards used to measure these behaviors were below average, average, or above average.
Father’s, at 36 years of age, were measured according to their occupation, sex, and social class in 1961 in terms of psychiatric disorder and physical symptoms. A semi-structured psychiatric interview generating levels of severity of psychiatric disorder and self-reported physical symptoms were conducted. Subjects who suffered from inflammatory bowel disease during adulthood were identified. Death records were analyzed to determine if persistent abdominal pain in childhood was related to increased mortality.
There were three main findings of the study. Firstly, children whose parents suffered from ill health were more likely to suffer from persistent abdominal pain. Secondly, although persistent abdominal pain in childhood did no predict abdominal pain in adulthood, abdominal pain was modestly associated with other common physical symptoms in adulthood. The study also found persistent abdominal pain in childhood was in indicator of psychiatric disorders in adulthood. At age 7, a fifth of the subjects had suffered abdominal pain; at 11 years it was 19%, and at 15 years it was 17%. Seventy-six of the 3637 children studied had recurrent abdominal pain. Of these, three had pain caused by chronic disease and 73 had persistent pain of unexplained origin. As it relates to the sexes, the children who participated in the study did not exhibit any difference in persistent abdominal pain (odds ratio to girls 0.97; 95%, 0.56 to 1.68). Children whose fathers had manual occupations were more likely to suffer from pain (1.75; to 1.02 to 3.03). The study revealed a connection between pain and parental health complaints, parental ratings of health, maternal nerves, maternal neuroticism, and families who were prone to colds.
The survey conducted by teachers showed no relationship between persistent abdominal pain and children who were disobedient, liars, or those with disciplinary problems. Daydreaming in class and having low energy was found to be related to persistent abdominal pain, and children who were more frequently absent from school suffered from abdominal pain during their early years (6-10), but there was no significant increase of school absence when the child was 13 years of age.
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