title: Recurrent pain, emotional distress, and health service use in childhood.
abstract: OBJECTIVE
  To determine the psychosocial correlates of recurrent pediatric pain and its relationship to health service use and medical presentations for "unexplained" symptoms in primary care.
  
  
  METHODS
  Children 4 to 15 years of age who complained frequently of aches and pains to parents were compared with those with infrequent or no pain on measures of demographics, psychopathology, school attendance and performance, perceived health, and service use. Univariate analysis was followed by logistic regression.
  
  
  RESULTS
  Children who complained often of aches and pains used more health services, had more psychosocial problems, missed more school, and did worse academically. After controlling for health service use and demographics, recurrent pain was significantly associated with negative parental perceptions of child health and the presence of internalizing psychiatric symptoms. Higher levels of ambulatory health service use were associated with negative perceptions of child health, recurrent pain, visits for "unexplained" symptoms, and internalizing psychiatric symptoms.
  
  
  CONCLUSIONS
  Pediatric recurrent pain challenges traditional service delivery models characterized by segregated systems of care for physical and mental disorders. Longitudinal and psychobiological studies of the relationship between recurrent pain, internalizing psychopathology, and health beliefs are warranted to direct future treatment efforts.
authors.affiliation: Western Psychiatric Institute and Clinic, the Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
authors.forename: John V
authors.initials: JV
authors.lastname: Campo
authors.forename: Diane M
authors.initials: DM
authors.lastname: Comer
authors.forename: Linda
authors.initials: L
authors.lastname: Jansen-Mcwilliams
authors.forename: William
authors.initials: W
authors.lastname: Gardner
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Kelleher
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006300:Health Services Misuse; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010146:Pain / Q000523:psychology*; D011602:Psychophysiologic Disorders / Q000453:epidemiology*; D011647:Puerto Rico / Q000453:epidemiology; D012008:Recurrence; D012917:Social Adjustment; D012944:Social Support; D014481:United States / Q000453:epidemiology