Pojavnost in značilnosti psihopatoloških simptomov pri otrocih in mladostnikih z nekardiološko bolečino za prsnico in funkcionalnimi gastroenterološkimi motnjami

Pintarič, Eva (author), Masten, Robert (mentor), Gosar, David (comentor)

Nekardiološka bolečina za prsnico in funkcionalne gastroenterološke motnje spadajo med pogostejše pediatrične funkcionalne somatske simptome, zaradi katerih mladi in njihovi starši iščejo pomoč v zdravstvenih ustanovah. Poleg bolečin in funkcionalnih okvar so tem funkcionalnim simptomom pogosto pridruženi psihopatološki simptomi. V raziskavi smo proučevali pojav simptomov anksioznosti in depresivnosti v slovenski pediatrični populaciji z nekardiološko bolečino za prsnico in funkcionalnimi gastroenterološkimi simptomi ter njihov vpliv na kakovost življenja v primerjavi s kontrolno skupino. Obenem smo preverili razlike v rezultatih glede na ocenjevalca. V raziskavi smo primerjali 69 otrok in mladostnikov z nekardiološko bolečino za prsnico ter 42 mladih s funkcionalnimi gastroenterološkimi motnjami, ki so pomoč poiskali v sprejemno-triažni ambulanti Pediatrične klinike, UKC Ljubljana, z 62 zdravimi vrstniki. Otroci in mladostniki ter njihovi starši so na Standardiziranem presejalnem vprašalniku SCARED in Achenbachovem sistemu empirično utemeljenega ocenjevanja psihosocialnega delovanja ASEBA poročali o otrokovih psihopatoloških simptomih, na Pediatričnem vprašalniku o kakovosti življenja PedsQL pa so ocenili njegovo kakovost življenja. Ugotovili smo izrazit učinek interakcije med raziskovalno skupino in ocenjevalcem. Mladi z obema vrstama funkcionalnih simptomov so navajali manj simptomov anksioznosti in depresije ter poročali, da imajo boljšo ali enako kakovost na večini področij svojega življenja (razen na telesnem področju) v primerjavi z zdravimi vrstniki. Njihovi starši so navajali ravno nasprotno. Pri mladih s funkcionalnimi simptomi so poročali o povišanih ravneh simptomov anksioznosti ter znižani kakovosti življenja na vseh področjih glede na zdrave vrstnike. Izkazalo se je, da so pri mladih iz obeh kliničnih skupin prisotne primerljive ravni psihopatoloških simptomov, izmerjenih na vprašalnikih SCARED in ASEBA. Interakcija med raziskovalno skupino in ocenjevalcem potrjuje ugotovitve predhodnih raziskav, ki poročajo o zmanjšanjem čustvenem zavedanju oz. aleksitimiji pediatričnih bolnikov s funkcionalnimi somatskimi simptomi, obenem pa naši izsledki opozarjajo na pomen zbiranja psihodiagnostičnih informacij s strani več ocenjevalcev. Zaradi okrnjene kakovosti življenja te skupine mladih opozarjamo na pomen zgodnjega presejanja in učinkovite psihološke podpore otrokom in mladostnikom pri spoprijemanju z bremeni pediatričnih funkcionalnih simptomov ter pridruženih psihosocialnih težav.

• Language: Slovenian
• Keywords: otroci in mladostniki, nekardiološka bolečina za prsnico, funkcionalne gastroenterološke motnje, težave ponotranjanja, kakovost življenja
• Work type: Master's thesis/paper
• Organization: FF - Faculty of Arts
• Year: 2024
• PID: 20.500.12556/RUL-159766
• Publication date in RUL: 24.07.2024

Secondary language

• Language: English
• Title: Prevalence and Characteristics of Psychopathological Symptoms in Children and Adolescents with Non-Cardiac Chest Pain and Functional Gastrointestinal Disorders

Abstract

Non-cardiac chest pain and functional gastrointestinal disorders are among the more common pediatric functional somatic symptoms for which youth and their parents seek treatment at healthcare institutions. In addition to the co-morbid pain and functional impairment, these functional symptoms are often associated with psychopathological symptoms. The aim of our study was to investigate the prevalence of anxiety and depression symptoms in the Slovenian population of children and adolescents with non-cardiac chest pain and functional gastrointestinal symptoms as well as to assess their impact on the quality of life in this population. We also examined differences in outcomes when taking into account the effect of the rater. We compared 69 children and adolescents with non-cardiac chest pain and 42 youth with functional gastrointestinal disorders, who sought help in the admission and triage clinic of the Pediatric Clinic, UKC Ljubljana, with a group of 62 healthy peers. Children and their parents reported on their child's psychopathological symptoms using the Screen for Child Anxiety Related Disorders (SCARED) and the Achenbach System of Empirically Based Assessment (ASEBA), while their quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL). We found a significant interaction effect between our study groups and the rater. Youth with both types of functional symptoms reported fewer anxiety and depression symptoms and rated their quality of life as equal or better than that of their healthy peers in most scales (except for the physical scale). On the other hand, their parents reported the exact opposite. For youth with functional symptoms parents reported an increased levels of anxiety symptoms and a reduced quality of life across all domains compared to their healthy peers. We also found that youth from both clinical groups have comparable levels of psychopathological symptoms as measured by the SCARED and ASEBA questionnaires. Our results showing an interaction between research group and rater support earlier findings showing reduced emotional awareness or alexithymia in pediatric patients with functional somatic symptoms. Our findings also highlight the importance of using multi-rater psychological assessment. Given the impaired quality of life in this group of youth, we highlight the importance of early screening and effective psychological support for children and adolescents coping with the burden of pediatric functional symptoms and associated psychosocial issues.

• Keywords: children and adolescents, non-cardiac chest pain, functional gastrointestinal disorders, internalizing problems, quality of life