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Battison EAJ, Brown PCM, Holley AL, Wilson AC. Associations between Chronic Pain and Attention-Deficit Hyperactivity Disorder (ADHD) in Youth: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010142. [PMID: 36670692 PMCID: PMC9857366 DOI: 10.3390/children10010142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/12/2023]
Abstract
Background: Chronic pain and ADHD are common conditions among youth that negatively impact functioning. This review fills a critical gap by summarizing current research on chronic pain and ADHD comorbidity, and it proposes a conceptual model of shared associations and underlying mechanisms. Objective: The aims of the current study were to: (1) review the extant literature and present estimates of the prevalence of comorbid non-headache chronic pain and ADHD in youth and (2) describe potential shared mechanisms for ADHD and chronic non-headache pain in youth. We also outline future directions to inform future research and interventions directed to youth with comorbid pain and ADHD. Design: A scoping review of the literature was performed in MEDLINE, PsycInfo, and Cochrane Database of Systematic Reviews using a wide range of search terms related to pain, Attention Deficit-Hyperactivity Disorder, childhood, adolescence, and young adulthood. Results: Eleven published studies were included in the review. These studies examined the prevalence of chronic pain among youth with ADHD, the prevalence of ADHD in chronic pain samples, and the association between chronic pain and ADHD among youth. Findings revealed results from studies indicating a higher prevalence of ADHD among youth with chronic pain and a higher prevalence of chronic pain in samples of youth with ADHD. Conclusions: Findings from this scoping review suggest an association between chronic pain and ADHD among youth. Little research was found to examine the etiology of this association. Future studies should examine underlying mechanisms of comorbid chronic pain and ADHD.
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Affiliation(s)
- Eleanor A. J. Battison
- Oregon Health & Science University School of Medicine, Portland, OR 97239, USA
- Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
- Correspondence: ; Tel.: +1-971-254-5648
| | - Patrick C. M. Brown
- Oregon Health & Science University School of Medicine, Portland, OR 97239, USA
| | - Amy L. Holley
- Oregon Health & Science University School of Medicine, Portland, OR 97239, USA
- Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Anna C. Wilson
- Oregon Health & Science University School of Medicine, Portland, OR 97239, USA
- Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
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Devanarayana NM, Rajindrajith S, Perera MS, Nishanthanie SW, Karunanayake A, Benninga MA. Association between functional gastrointestinal diseases and exposure to abuse in teenagers. J Trop Pediatr 2014; 60:386-92. [PMID: 25059210 DOI: 10.1093/tropej/fmu035] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Abdominal pain-predominant functional gastrointestinal diseases (AP-FGD) are common in children and commonly attributed to exposure to child abuse. However, this relationship has not been studied in teenagers, and the main objective of the current study was to assess it. Teenagers were recruited from four randomly selected schools in Western province of Sri Lanka. Data were collected using a validated self-administered questionnaire. AP-FGD were diagnosed using Rome III criteria. A total of 1850 teenagers aged 13-18 years were included. Three hundred and five (16.5%) had AP-FGD. AP-FGD were significantly higher in those exposed to sexual (34.0%), emotional (25.0%) and physical (20.2%) abuse, than in those not abused (13.0%, p < 0.001). Those with AP-FGD exposed to abuse had a higher severity score for bowel symptoms (30.8% vs. 24.7% in not abused, p < 0.05). This study highlights the importance of identifying exposure to abuse in management of teenagers with AP-FGD.
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Affiliation(s)
| | - Shaman Rajindrajith
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Sri Lanka
| | - Madushanka S Perera
- Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Sri Lanka
| | - Samudu W Nishanthanie
- Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Sri Lanka
| | - Amaranath Karunanayake
- Department of Physiology, Faculty of Medicine, University of Ruhuna, Karapitiya, Galle 80000, Sri Lanka
| | - Marc A Benninga
- Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Centre, 1105 AZ, Amsterdam, The Netherlands
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Abstract
BACKGROUND AND OBJECTIVES A history of sexual abuse is to be found in approximately 40% of all adult patients with gastrointestinal complaints. Data on the prevalence of child sexual abuse (CSA) in children with chronic abdominal pain (CAP) are lacking. The objective of this systematic review is to determine the prevalence of CSA in pediatric patients with CAP. METHODS We conducted a systematic literature search in the electronic databases MEDLINE, EMBASE, PsychInfo, and ERIC. Reference lists of relevant articles were scanned for additional citations. We selected case-control, cohort and cross-sectional studies investigating the prevalence of CSA in children with CAP, ages 0 to 18 years. Data were extracted from relevant studies, which were assessed for methodological quality by 2 independent reviewers. Prevalence of CSA was the main outcome measure. RESULTS The literature search yielded a total of 269 articles. Only 2 studies met our inclusion criteria, reporting CSA in 2.1% and 8.0% of children (age range 4-21 years) with CAP. Both studies were conducted in small groups (n = 48 and n = 50) without control group(s) and did not use standardized or validated instruments for diagnosing CSA. CONCLUSIONS According to existing data, the prevalence of a history of CSA in pediatric patients with CAP is lower than in adult patients; however, no well-designed studies have been conducted in children. Future research is required to determine a reliable prevalence of CSA in children with CAP.
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Bell KM, Meadows EA. Efficacy of a Brief Relaxation Training Intervention for Pediatric Recurrent Abdominal Pain. COGNITIVE AND BEHAVIORAL PRACTICE 2013. [DOI: 10.1016/j.cbpra.2012.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ghanizadeh A, Moaiedy F, Imanieh MH, Askani H, Haghighat M, Dehbozorgi G, Dehghani SM. Psychiatric disorders and family functioning in children and adolescents with functional abdominal pain syndrome. J Gastroenterol Hepatol 2008; 23:1132-6. [PMID: 18005012 DOI: 10.1111/j.1440-1746.2007.05224.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM Functional abdominal pain syndrome (FAPS) is a functional gastrointestinal disorder. There is a heightened risk when conducting potentially dangerous and unnecessary medical investigations and procedures in children with FAPS. The aim of this study was to survey the rate of the psychiatric disorders and family functioning in children and adolescents with FAPS. METHODS The subjects were a consecutive new sample of 45 children and adolescents with FAPS, 45 with an organic abdominal pain, and 45 pain-free comparison subjects aged 5-18 years that were interviewed using the Farsi version of K-SADS. Family functioning and the severity of pain were also studied. RESULTS About 51.1% of patients with FAPS suffered from at least one psychiatric disorder. Psychiatric disorders in the FAPS patients studied included general anxiety disorder (8.9%), obsessive-compulsive disorder (11.1%), attention deficit hyperactivity disorder (15.6%), separation anxiety disorder (24.4%), and major depressive disorder (15.6%). Except for generalized anxiety disorder and tic disorder, the other disorders were significantly more common in the FAPS group than in the two other control groups. Family functioning scores were not significantly different between groups. DISCUSSION There is a high rate of psychiatric disorders in children and adolescents with FAPS in Iran, but our study found fewer incidences of disorders than previous reports have indicated. Family dysfunction difficulties in FAPS children are not more common than those in the control groups.
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Affiliation(s)
- Ahmad Ghanizadeh
- Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Kaminsky L, Robertson M, Dewey D. Psychological correlates of depression in children with recurrent abdominal pain. J Pediatr Psychol 2006; 31:956-66. [PMID: 16514051 DOI: 10.1093/jpepsy/jsj103] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the associations between coping style, social support, self-efficacy, locus of control, maternal adjustment, and depressive symptoms in children with recurrent abdominal pain (RAP) of childhood. METHODS Fifty children with RAP (8-18 years) and their mothers were recruited from a gastroenterology clinic (GI) and community medical practices. Participants completed questionnaires that assessed coping style, social support, self-efficacy, locus of control, maternal adjustment, and psychological adjustment. RESULTS Passive coping strategies such as isolating oneself from others, catastrophizing, and behavioral disengagement were associated with more child-reported depressive symptoms. Higher levels of self-efficacy and greater social support from teachers and classmates were associated with fewer child-reported depressive symptoms. Higher levels of maternal adjustment problems, higher social support from parents, and lower social support from classmates were associated with maternal reports of more child internalizing symptoms. CONCLUSIONS These findings suggest that coping style, self-efficacy, social support, and maternal adjustment are correlates of depressive symptoms in children with RAP.
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Affiliation(s)
- Laura Kaminsky
- Department of Psychology, University of Calgary, Canada.
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Hagekull B, Bohlin G. Predictors of middle childhood psychosomatic problems: An emotion regulation approach. INFANT AND CHILD DEVELOPMENT 2004. [DOI: 10.1002/icd.366] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Stickler GB. Recurrent abdominal pain. PEDIATRIC CASE REVIEWS (PRINT) 2002; 2:95-9. [PMID: 12865686 DOI: 10.1097/00132584-200204000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Gunnar B Stickler
- Department of Pediatrics and Adolescent Medicine (Emeritus member), Mayo Clinic and Mayo Medical School, Rochester, MN
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Burke P, Elliott M, Fleissner R. Irritable bowel syndrome and recurrent abdominal pain. A comparative review. PSYCHOSOMATICS 1999; 40:277-85. [PMID: 10402871 DOI: 10.1016/s0033-3182(99)71219-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Clinical findings on irritable bowel syndrome in adults and recurrent abdominal pain in children are reviewed to determine if what is known about each disorder can illuminate our understanding of the other. The evidence reveals striking similarities between the disorders in prevalence, course, medical and psychiatric comorbidity, family medical and psychiatric history, and association with life events. Continuity between the two disorders is also suggested by the results of follow-up and follow-back studies. The review shows the importance of a developmental perspective for understanding functional bowel disorders in adults and points to areas where further research would be useful.
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Affiliation(s)
- P Burke
- University of Arizona Health Sciences Center, Department of Psychiatry, Tucson 85724-5002, USA.
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Little L. The misunderstood child: the child with a nonverbal learning disorder. JOURNAL OF THE SOCIETY OF PEDIATRIC NURSES : JSPN 1999; 4:113-21; quiz 123-4. [PMID: 10472543 DOI: 10.1111/j.1744-6155.1999.tb00044.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ISSUES AND PURPOSE To introduce nurses to the characteristics of nonverbal learning disorders (NLD) and their psychosocial trajectory in children. Despite the prevalence of learning disorders in children, few nursing professionals are familiar with NLD and their manifestations. CONCLUSIONS The child with NLD faces unique challenges in the social, academic, visual-spatial, motoric, and emotional spheres. PRACTICE IMPLICATIONS Nurses can play a vital role in the identification, education, and provision of resources for these children.
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Affiliation(s)
- L Little
- Department of Nursing, University of New Hampshire, Durham, USA.
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Hotopf M, Carr S, Mayou R, Wadsworth M, Wessely S. Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. BMJ (CLINICAL RESEARCH ED.) 1998; 316:1196-200. [PMID: 9552994 PMCID: PMC28520 DOI: 10.1136/bmj.316.7139.1196] [Citation(s) in RCA: 246] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/1997] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To test the hypotheses that children with abdominal pain have anxious parents and come from families with high rates of physical illness and that they grow up to suffer from high rates of medically unexplained symptoms and psychiatric disorders. DESIGN Population based birth cohort study. SETTING General population. SUBJECTS Participants in the Medical Research Council (MRC) national survey of health and development, a population based birth cohort study established in 1946. MAIN OUTCOME MEASURES Abdominal pain present throughout childhood in the absence of defined organic disease, and measures of physical symptoms and psychiatric disorder at age 36 years. RESULTS There were high rates of complaints about physical health among the parents of children with persistent abdominal pain, and the mothers had higher neuroticism scores. Children with persistent abdominal pain were more likely to suffer from psychiatric disorders in adulthood (odds ratio 2.72 (95% confidence interval 1.65 to 4.49)) but were not especially prone to physical symptoms once psychiatric disorder was controlled for (odds ratio 1. 39 (0.83 to 2.36)). CONCLUSIONS Persistent abdominal pain is associated with poor health and emotional disorder in the parents. Children with abdominal pain do not necessarily continue to experience physical symptoms into adulthood but are at increased risk of adult psychiatric disorders.
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Affiliation(s)
- M Hotopf
- Department of Psychological Medicine, King's College School of Medicine and Dentistry and Institute of Psychiatry, London SE5 8AZ, UK.
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Lamdan RM, Ramchandani D, Schindler BA. The chronically mentally ill on a general hospital consultation-liaison service. Their needs and management. PSYCHOSOMATICS 1997; 38:472-7. [PMID: 9314716 DOI: 10.1016/s0033-3182(97)71424-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The consultation-liaison (C-L) psychiatrist often sees chronic mentally ill patients when they are admitted to the medical-surgical services of the general hospital. Little research has been directed to the special needs and concerns of these patients in the general hospital. This area has become more relevant now that many of these patients are no longer cared for in the safety of the state hospital setting, often making baseline medical histories inaccessible. They have an overall higher mortality rate than the general population, cannot give adequate histories, and their psychotic illness can mask an underlying medical illness. In this preliminary investigation of the problems of this special population, the authors examined the issues concerning nursing needs, length of hospital stay, medical diagnosis, and possible complicating problems encountered during these patients' hospital stays in the setting of an urban university hospital. The authors discuss the implications of the role of the C-L psychiatrist in addressing their patients' acute problems.
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Affiliation(s)
- R M Lamdan
- Department of Psychiatry, Allegheny University Hospitals, Philadelphia, Pennsylvania, USA
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Scharff L. Recurrent abdominal pain in children: a review of psychological factors and treatment. Clin Psychol Rev 1997; 17:145-66. [PMID: 9140713 DOI: 10.1016/s0272-7358(96)00001-3] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This paper reviews current knowledge regarding recurrent abdominal pain (RAP) and the physiological, dietary, and psychological variables that may have some influence in pain episodes. Emphasis is placed on psychological factors and studies that have investigated psychological treatment modalities. There is some limited evidence of physiological dysfunction in RAP patients, and while some researchers have asserted that RAP may be a dietary disorder, results of several studies do not support this assertion. Studies examining psychological variables in RAP patients show elevated anxiety levels; however, elevated anxiety is also associated with organic abdominal pain. Psychological treatments focusing on cognitive-behavioral methods have demonstrated success in treating RAP. Follow-up studies are needed to determine the long-term success of these treatments, and continued research examining which children benefit from treatment would also be beneficial.
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Affiliation(s)
- L Scharff
- University of Pittsburgh Medical Center, PA, USA
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Yoshida NR, Webber EM, Fraser RB, Ste-Marie MT, Giacomantonio JM. Helicobacter pylori is not associated with nonspecific abdominal pain in children. J Pediatr Surg 1996; 31:747-9. [PMID: 8783091 DOI: 10.1016/s0022-3468(96)90121-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Nonspecific abdominal pain is a significant problem in the pediatric population, and there has been much recent interest in the role that Helicobacter pylori (HP) might play in this disorder. A retrospective review was conducted at our center to determine its prevalence among children with otherwise undiagnosed abdominal pain. The study was conducted over a 45-month period during which 47 patients underwent gastroscopy and antral biopsies in the workup of this problem. Of the 37 patients who did not have a history of acid-pepsin disease (APD), only one (2.7%) tested positive for HP. In contrast, of the 10 who had a history of APD, three (30%) tested positive (P < .03). There were no distinguishing features among the HP-positive patients except for the presence of associated antral gastritis. Based on the current endoscopic results, of the nine patients with current evidence of APD, four (44%) were positive for HP; of the other 38 patients, none was positive for HP. Therefore, HP appears to be associated with antral gastritis, and HP does not play a role in nonspecific abdominal pain in this population.
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Affiliation(s)
- N R Yoshida
- Izaak Walton Killam Hospital for Sick Children, Halifax, Nova Scotia, Canada
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