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.
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