Prevalence, Patterns, and Correlates of Pain in Medically Hospitalized Pediatric Patients With Somatic Symptom and Related Disorders.


Journal

Journal of the Academy of Consultation-Liaison Psychiatry
ISSN: 2667-2960
Titre abrégé: J Acad Consult Liaison Psychiatry
Pays: Netherlands
ID NLM: 101775059

Informations de publication

Date de publication:
Historique:
received: 08 03 2020
revised: 13 05 2020
accepted: 13 05 2020
pubmed: 10 7 2020
medline: 26 11 2021
entrez: 10 7 2020
Statut: ppublish

Résumé

Somatic symptom and related disorders (SSRDs) and pain are highly comorbid in the pediatric population. Little is known about the prevalence of pain and factors that may predispose and perpetuate pain in hospitalized youth with SSRD. To describe the prevalence of pain and widespread pain symptoms in hospitalized youth with SSRD and describe differences between patients who endorsed limited (1-4 sites) versus widespread (5-8 sites) pain. Retrospective chart reviews were conducted of pediatric patients with SSRD seen over a 32-month period at a tertiary pediatric hospital and assessed by the psychiatry consultation service. During admission, patients completed the Childhood Somatization Inventory, which assessed pain and other physical symptoms. Descriptive statistics, one-way analysis of variances, Pearson's χ Of the 219 patients (aged 8-18 y), 97% reported pain symptoms, and of those reporting pain (n = 213), 48% reported widespread pain. Patients with widespread pain had greater rates of comorbid depression (P = 0.012), neglect (P = 0.016), family psychiatric history (P = 0.013), diagnostic tests/procedures (P = 0.012), and prescribed opioid use (P = 0.016), when other medical and demographic factors were considered. When compared dichotomously to youth with limited pain, there was no difference in prevalence of medical conditions; however, patients with widespread pain had higher rates of trauma and stressor-related disorders (P = 0.017), sexual abuse (P = 0.031), emotional abuse (P = 0.041), and prior child protective service involvement (P = 0.011). Pain symptoms and widespread pain are common in medically hospitalized youth with SSRD, with unique psychiatric and psychosocial factors associated with widespread pain.

Sections du résumé

BACKGROUND
Somatic symptom and related disorders (SSRDs) and pain are highly comorbid in the pediatric population. Little is known about the prevalence of pain and factors that may predispose and perpetuate pain in hospitalized youth with SSRD.
OBJECTIVE
To describe the prevalence of pain and widespread pain symptoms in hospitalized youth with SSRD and describe differences between patients who endorsed limited (1-4 sites) versus widespread (5-8 sites) pain.
METHODS
Retrospective chart reviews were conducted of pediatric patients with SSRD seen over a 32-month period at a tertiary pediatric hospital and assessed by the psychiatry consultation service. During admission, patients completed the Childhood Somatization Inventory, which assessed pain and other physical symptoms. Descriptive statistics, one-way analysis of variances, Pearson's χ
RESULTS
Of the 219 patients (aged 8-18 y), 97% reported pain symptoms, and of those reporting pain (n = 213), 48% reported widespread pain. Patients with widespread pain had greater rates of comorbid depression (P = 0.012), neglect (P = 0.016), family psychiatric history (P = 0.013), diagnostic tests/procedures (P = 0.012), and prescribed opioid use (P = 0.016), when other medical and demographic factors were considered. When compared dichotomously to youth with limited pain, there was no difference in prevalence of medical conditions; however, patients with widespread pain had higher rates of trauma and stressor-related disorders (P = 0.017), sexual abuse (P = 0.031), emotional abuse (P = 0.041), and prior child protective service involvement (P = 0.011).
CONCLUSIONS
Pain symptoms and widespread pain are common in medically hospitalized youth with SSRD, with unique psychiatric and psychosocial factors associated with widespread pain.

Identifiants

pubmed: 32641234
pii: S0033-3182(20)30146-8
doi: 10.1016/j.psym.2020.05.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

46-55

Informations de copyright

Copyright © 2020 Academy of Consultation-Liaison Psychiatry. Published by Elsevier Inc. All rights reserved.

Auteurs

Patricia Ibeziako (P)

Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA. Electronic address: Patricia.Ibeziako@childrens.harvard.edu.

Edin Randall (E)

Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA.

Areti Vassilopoulos (A)

Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA.

Christine Choi (C)

Department of Psychiatry, Boston Children's Hospital, Boston, MA.

Katharine Thomson (K)

Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA.

Monique Ribeiro (M)

Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA.

Serena Fernandes (S)

Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA.

Robyn Thom (R)

Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA.

Simona Bujoreanu (S)

Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA.

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Classifications MeSH