The role of coping with symptoms in depression and disability: Comparison between Inflammatory Bowel Disease and Abdominal Pain

Inflammatory Bowel Disease (IBD) and abdominal pain of functional origin (AP) are common gastrointestinal disorders in children that are associated with increased risk for depression and disability. Both symptom severity and coping with symptoms may contribute to these outcomes. We hypothesized that children with AP use different coping strategies compared to those with IBD for a number of reasons, including the fact that fewer treatment options are available to them. We also examined if coping was related to depression and functional disability beyond the contributions of symptom severity

Effects of a Cognitive Behavioral Therapy Intervention Trial to Improve Disease Outcomes in Children with Inflammatory Bowel Disease:

Studies testing the efficacy of behavioral interventions to modify psychosocial sequelae of IBD in children are limited. This report presents outcomes through a six month follow up from a large RCT testing the efficacy of a cognitive-behavioral intervention for children with IBD and their parents

Psychological Distress and Quality of Life in Pediatric Crohn Disease: Impact of Pain and Disease State.

OBJECTIVES: For patients with Crohn disease (CD), symptom reporting may not coincide with disease state; patients in remission may continue to report symptoms and pain, whereas other patients may be symptom-free despite a flare. This phenomenon has been documented in adults but only recently assessed in pediatric patients. The present study assessed the role of pain reporting and diseasestate in pediatric patients with CD in understanding psychological distress and quality of life. METHODS: Participants included 116 children and adolescents ages 8 to 18 years with CD who completed self-report questionnaires assessing pain, disease symptoms, depression, anxiety, functional disability, and quality of life. Physicians completed the Pediatric Crohn\u27s Disease Activity Index to assess disease activity (scores ≤10 = remission, scores \u3e10 = flare). RESULTS: Approximately two thirds of participants reported pain concordant with disease state. For patients in remission, those with painexperienced significantly increased disability and decreased quality of life compared to patients in remission without pain. For patients in a flare, those without pain experienced significantly decreased disability and depressive symptoms, and improved quality of life compared to patients in a flare with pain. CONCLUSIONS: For pediatric patients with CD, report of pain, while in remission or a flare, is associated with increased disability and reduced quality of life. Although levels of depression did not differ by disease state, depressive symptoms did differ by pain report (presence or absence) for those in a flare. Pain reporting in CD appears to be associated with both physical and psychological state and should be assessed regardless of disease activity