title: Importance of parental conceptual model of illness in severe recurrent abdominal pain.
abstract: OBJECTIVE
  Recurrent abdominal pain (RAP) affects up to 15% of children. A biopsychosocial approach to the treatment of children with RAP has been proposed as an alternative to the traditional medical model. The aim of this study was to examine whether the parental conceptual model of illness is a factor in the long-term outcome of children with severe RAP.
  
  
  METHODS
  The study was undertaken in 2 parts: 1) a review of the medical and psychiatric records (including Child Behavior Checklist [CBCL]) of all children with RAP of sufficient severity to necessitate hospitalization during a 5-year period and 2) a structured telephone interview to collect information on ongoing abdominal pain, other somatic symptoms, school attendance, and the parents' opinion as to the cause of the child's pain.
  
  
  RESULTS
  Twenty-eight of 30 children who were identified were available for follow-up. Twenty-three (82%) were tertiary referrals from other pediatric services, and 20 had pain for >6 months. On admission 7 (25%) of 28 had a depressive disorder, and 8 (29%) had an anxiety/depressive disorder. Twenty-one of 28 parents completed the CBCL, and on analysis of the CBCL, 11 (52%) children had scores in the clinical range (>65). At follow-up (mean: 3.56 years; standard deviation: 1.59), 14 (50%) of 28 continued to complain of pain. These children also complained of multiple other somatic complaints and had repeated school absences. Only 1 (7%) of 14 parents of children with ongoing pain believed that there was a psychological cause for their child's pain, whereas 11 (78%) of 14 parents of the children who had recovered believed that the cause was attributable to psychological factors (odds ratio: 47.67; 95% confidence interval: 3.56-1511.6).
  
  
  CONCLUSIONS
  The acceptance by parents of a biopsychosocial model of illness is important for the resolution of recurrent abdominal pain in children.
authors.affiliation: Department of Paediatrics, Conway Institute for Biomolecular and Biomedical Research, University College, Dublin, Ireland.
authors.forename: Ellen
authors.initials: E
authors.lastname: Crushell
authors.forename: Marion
authors.initials: M
authors.lastname: Rowland
authors.forename: Mairin
authors.initials: M
authors.lastname: Doherty
authors.forename: Siobhan
authors.initials: S
authors.lastname: Gormally
authors.forename: Sinead
authors.initials: S
authors.lastname: Harty
authors.forename: Billy
authors.initials: B
authors.lastname: Bourke
authors.forename: Brendan
authors.initials: B
authors.lastname: Drumm
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D002648:Child; D002665:Child Psychiatry; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005762:Gastroenterology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D008960:Models, Psychological; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D012008:Recurrence; D013315:Stress, Psychological