FROM CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
Nausea appears to be an independent risk factor for current and future anxiety and depression in children with functional abdominal pain (FAP), reported Alexandra C. Russell, MD, and her associates at Vanderbilt University, Nashville.
In a study of 398 children with FAP and nausea and 479 with FAP alone, those with comorbid nausea had significantly more GI symptoms and depression symptoms. Anxiety symptoms were not studied. Mean age at baseline was 12 years.
At follow-up, when patients were a mean 21 years of age, patients with FAP and nausea still reported greater abdominal pain severity and significantly greater depressive and anxious symptoms, compared with FAP-only patients.
The FAP plus nausea patients were 1.79-times more likely to meet criteria for a current DSM-IV anxiety disorder and 2.61-times more likely to meet DSM-IV diagnostic criteria for generalized anxiety disorder than were FAP-only patients. The FAP and nausea patients were 1.81 times more likely to meet criteria for a DSM-IV for a major depressive disorder in their lifetime than were FAP-only patients.
The suggestion that nausea may be an independent risk factor for later anxiety and depression in children with FAP “may be owing to chronic nausea being a distressing symptom that permeates multiple areas of physical and psychosocial functioning,” Dr. Russell and her colleagues surmised.
“It may be difficult for these patients to maintain good nutrition, sleep habits, exercise, and resiliency when they frequently are nauseated,” the study authors noted. “Alternatively, FAP patients with comorbid nausea may represent a phenotype with autonomic nervous system dysfunction that contributes to both nausea and emotional distress.”
Read more in Clinical Gastroenterology and Hepatology ( 2017 May;15[5]:706-11 ).
