Relationship between the decision to take a child to the clinic for abdominal pain and maternal psychological distress.
BACKGROUND
Among adults with functional gastrointestinal disorders, psychological distress influences who consults a physician, but little is known about predictors of consultation when the patient is a child.


OBJECTIVE
To determine the relative contributions of psychological symptoms of the mother, psychological symptoms of the child, severity of child abdominal pain, and family stress to consultation.


METHODS
Observational study.


METHODS
Health maintenance organization.


METHODS
Two hundred seventy-five mothers of 334 children who had abdominal pain in the past 2 weeks, as per child self-report.


METHODS
Mothers completed questionnaires about themselves (Symptom Checklist 90-Revised) and their children (school absences, medication use, and the Child Behavior Checklist). Children completed the Pain Beliefs Questionnaire to assess perceived pain severity.


RESULTS
Thirty-nine children had been taken to the clinic for abdominal pain symptoms at least once in the past 3 months (consulters), whereas 295 were nonconsulters. Logistic regression analyses revealed that both the child's self-report of perceived pain severity (P<.001) and maternal psychological symptoms (P = .006) predicted consultation. Although children who visited physicians had significantly more psychological symptoms, this was not a significant predictor of consultation after adjusting for maternal psychological symptoms. Family stress did not predict consultation.


CONCLUSIONS
The decision to take a child to the clinic for abdominal pain is best predicted by maternal psychological distress and the child's perceived pain severity.
Levy
Rona L
RL
School of Social Work and School of Medicine and Department of Psychology, University of Washington, and Lakeside School, Seattle, USA. rlevy@u.washington.edu
Langer
Shelby L
SL
Walker
Lynn S
LS
Feld
Lauren D
LD
Whitehead
William E
WE
D015746:Abdominal Pain / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D002648:Child; D003657:Decision Making; D006801:Humans; D016015:Logistic Models; D009035:Mothers / Q000523:psychology*; D010147:Pain Measurement; D011795:Surveys and Questionnaires