title: Behavioral functioning and treatment adherence in pediatric eosinophilic gastrointestinal disorders.
abstract: OBJECTIVE
  To examine behavioral predictors of treatment adherence in patients with eosinophilic gastrointestinal disorders (EGID).
  
  
  METHODS
  Participants were 96 patients 2.5-18 yr of age with eosinophilic esophagitis or eosinophilic gastroenteritis and their caregivers (mother, father). We assessed maternal and paternal report of child/adolescent internalizing symptoms (e.g., anxiety, depression) and externalizing symptoms (e.g., aggression, anger) using the Behavior assessment system for children, 2nd edition (BASC-2). A multi-informant adherence assessment approach and an 80% cut point were used to classify patients as adherent or non-adherent.
  
  
  RESULTS
  Sociodemographic predictors did not distinguish between adherent and non-adherent patients. Maternal report of internalizing symptoms significantly correlated with non-adherence (p < 0.001). Post hoc probing revealed a significant contribution of depression, with depressed patients being more likely (OR = 7.27; p < 0.05) to be non-adherent than non-depressed patients. Paternal report of internalizing and externalizing symptoms was not associated with non-adherence.
  
  
  CONCLUSIONS
  Maternal report of patient internalizing behavioral symptoms, particularly depression, is significantly associated with non-adherence in patients with EGID. These symptoms are potential risk factors and should be considered when assessing and treating non-adherence. Clinical care of patients with EGID should include routine screening for depression.
authors.affiliation: Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. kevin.hommel@cchmc.org
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Hommel
authors.forename: James P
authors.initials: JP
authors.lastname: Franciosi
authors.forename: Wendy N
authors.initials: WN
authors.lastname: Gray
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hente
authors.forename: Annette
authors.initials: A
authors.lastname: Ahrens
authors.forename: Marc E
authors.initials: ME
authors.lastname: Rothenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D004751:Enteritis / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D004802:Eosinophilia / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005756:Gastritis / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D012307:Risk Factors; D014481:United States; D055815:Young Adult; D016903:Drug Monitoring