Recurrent abdominal pain in children and adolescents – a survey among paediatricians

Objective: Little is known about prevalence and usual treatment of childhood and adolescent recurrent abdominal pain (RAP) in outpatient paediatricians’ practice. This study’s primary objective was to acquire insights into the usual paediatricians’ treatment and their estimation of prevalence, age and gender of RAP patients. Further objectives were to assess to which extent family members of patients report similar symptoms, how paediatricians rate the strain of parents of affected children and adolescents and how paediatricians estimate the demand for psychological support

Recurrent abdominal pain in children and adolescents – a survey among paediatricians

Objective: Little is known about prevalence and usual treatment of childhood and adolescent recurrent abdominal pain (RAP) in outpatient paediatricians’ practice. This study’s primary objective was to acquire insights into the usual paediatricians’ treatment and their estimation of prevalence, age and gender of RAP patients. Further objectives were to assess to which extent family members of patients report similar symptoms, how paediatricians rate the strain of parents of affected children and adolescents and how paediatricians estimate the demand for psychological support

Sleep Duration and Sleep Problems in a Representative Sample of German Children and Adolescents

Schlarb A, Gulewitsch MD, Weltzer V, Ellert U, Enck P. Sleep Duration and Sleep Problems in a Representative Sample of German Children and Adolescents. Health. 2015;07(11):1397-1408.Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects. Methods: A total of 17,641 subjects from the KiGGS study were evaluated. The questionnaires contained questions about physical health, living circumstances, health behavior and risks, health supply, mental health, health-related quality of life and sleep. KiGGS assessed sleep by using parent questionnaire of children aged 0 to 10 years (n = 9944) and self-reports of adolescents (n = 7697) aged 11 to 17 years. Results: Total sleep duration decreased from 14.28 hours (SD = 2.33) at the ages 0 - 0.5 to 9.50 hours (SD = 0.82) at the ages of 10.5 - 11. Above the age of 11 adolescents report a decrease of sleep at night from 9.41 hours (SD = 1.33) at the age of 11 - 11.5 to 7.42 (SD = 1.73) at the age of 17.5 - 18 years. Unspecified sleep problems were reported of 19.5%, 13.0% of the children had difficulties falling asleep, difficulties sleeping through the night showed 8.8% of the children, whereas 3.0% report both symptoms—difficulties falling asleep and difficulties sleeping through the night. Conclusions: Age-specific variability of sleep duration is reported as well as sleep difficulties from infancy to adolescence. This is important knowledge for the health care professional who deals with sleep problems in pediatric practice

Sleep and somatic complaints in university students

Schlarb A, Claßen M, Hellmann SM, Voegle C, Gulewitsch MD. Sleep and somatic complaints in university students. JOURNAL OF PAIN RESEARCH. 2017;10:1189-1199.Background: Sleep problems are common among university students. Poor sleep is associated with impaired daily functioning, increased risk of psychiatric symptoms, and somatic complaints such as pain. Previous results suggest that poor sleep exacerbates pain, which in turn negatively affects sleep. The purpose of the present study was to determine prevalence rates, comorbidity, and role of depression as a factor of moderating the relationship between sleep and physical complaints in German university students. Samples and methods: In total, 2443 German university students (65% women) completed a web survey. Self-report measures included the Pittsburg Sleep Quality Index, three modules of the Patient Health Questionnaire, and a questionnaire on the functional somatic syndromes (FSSs). Results: More than one-third (36.9%) reported poor sleep as assessed by the Pittsburgh Sleep Quality Index. Somatoform syndrome was identified in 23.5%, and the prevalence of any FSS was 12.8%. Self-reported sleep quality, sleep onset latency, sleep disturbances, use of sleep medications, and daytime dysfunctioning were significant predictors of somatoform syndrome, whereas sleep efficiency and sleep duration influenced somatic complaints indirectly. Moderate correlations were found between stress, anxiety, somatoform syndrome, depression, and overall sleep quality. The effect of somatic complaints on sleep quality was associated with the severity of depression. Anxiety shows direct effects on somatization and depression but only indirect associations with sleep quality

Comparison of gut-directed hypnotherapy and unspecific hypnotherapy as self-help format in children and adolescents with functional abdominal pain or irritable bowel syndrome

Gulewitsch MD, Schlarb A. Comparison of gut-directed hypnotherapy and unspecific hypnotherapy as self-help format in children and adolescents with functional abdominal pain or irritable bowel syndrome. European Journal of Gastroenterology & Hepatology. 2017;29(12):1351-1360.OBJECTIVE: Psychosocial treatments for chronic abdominal pain in childhood or adolescence are effective, but time consuming and hardly available. In the present study, gut-directed hypnotherapy (GDHT) and unspecific hypnotherapy (UHT) were compared to evaluate the feasibility and efficacy of a hypnotherapeutic self-help intervention. PARTICIPANTS AND METHODS: Children/adolescents between 6 and 17 years of age with chronic abdominal pain were randomized to GDHT or UHT. The treatment period was 12 weeks each. Measurements were performed before and after treatment. The primary outcome was a pain diary. Analysis was carried out as per protocol. RESULTS: Of 45 participants included, 13 were lost to follow-up. Thirty-two participants (14 GHDT, 18 UHT) were analyzed. Dropouts had higher pain severity. Completers in both conditions showed good adherence and a similar decrease in days with pain and pain duration. Pain intensity decreased only in the UHT condition. Eleven participants (two GDHT, nine UHT) achieved clinical remission (>80% improvement) and 13 participants (seven GDHT, six UHT) improved significantly (30-80%). CONCLUSION: Results suggest a high efficacy of standardized home-based hypnotherapy for children/adolescents with abdominal pain. Children/adolescents with high pain severity are at risk of dropping out. The UHT condition showed slight evidence of superiority, but conditions were equivalent on most outcomes. Taken together, self-help approaches based on hypnotherapy could close a treatment gap and prevent chronification

KVT bei funktionellen Bauchschmerzen

Gulewitsch MD, Schlarb A. KVT bei funktionellen Bauchschmerzen. In: Schlarb A, ed. Praxisbuch KVT mit Kindern und Jugendlichen. Störungsspezifische Strategien und Leitfäden. Weinheim: Beltz-Verlag; 2012: 315-352

Nightmares and Associations with Sleep Quality and Self-Efficacy among University Students

Schlarb A, Bihlmaier I, Hautzinger M, Gulewitsch MD, Schwerdtle B. Nightmares and Associations with Sleep Quality and Self-Efficacy among University Students. Journal of Sleep Disorders and Management. 2015;1: 2.Sleep problems are a common complaint among adults. In university students international studies showed prevalence rates between 4.7 and 36.2% for sleep difficulties and 2-3% of students report nightmares. Previous studies show that nightmares are often associated with insomnia and mental strain, but also with gender. The goal of this study was to outline nightmares, associations with sleep disturbances and mental strain as well as self-efficacy among university students. An amount of 2196 students (70.9% women; mean age 24.16 years) participated in the study. Sleep characteristics, nightmares, mental strain and self-efficacy were assessed by self-report questionnaires. Analyses revealed that more than 24.3% of surveyed students suffered from nightmares, 18.5% reported nightmares more often than once a week and 5.8% suffered from nightmares at least 3 times a week. Moreover, nightmares were associated with symptoms of insomnia and low self-efficacy was significantly associated with an increased rate of nightmares. Besides, a total of 52% of students reported fitful sleep

Mental strain and chronic stress among university students with symptoms of irritable bowel syndrome,” Gastroenterology Research and Practice, vol

Aim. To investigate the degree of mental strain and chronic stress in a German community sample of students with IBS-like symptoms. Methods and Materials. Following an internet-based survey about stress, this study recruited 176 German university students (23.45 ± 2.48 years; 48.3% males) with IBS-like symptoms according to Rome III and 181 students without IBS (23.55 ± 2.82 years; 50.3% males) and compared them regarding current mental strain (SCL-90-R) and the extend of chronic stress. Beyond this, IBS subtypes, IBS severity, and health care utilization were assessed. Results. Students fulfilling IBS criteria showed significantly elevated values of mental strain and chronic stress. Nearly 40% of the IBS group (versus 20% of the controls) reached a clinically relevant value on the SCL-90-R global severity scale. IBS subtypes did not differ in terms of mental distress or chronic stress. Somatization, anxiety, and the chronic stressors "work overload, " "social tension, " and "dissatisfaction with job" were most closely connected to IBS symptom severity. Regarding health care utilization, our results show that consulting a physician frequently was not associated significantly with elevated mental strain or chronic stress but with IBS symptom severity. Conclusion. Our data contribute additional evidence to the distinct association between psychological stress and IBS in community samples

Mental strain and chronic stress among a community sample of university students with irritable bowel syndrome symptoms

Gulewitsch MD, Enck P, Hautzinger M, Schlarb A. Mental strain and chronic stress among a communit sample of university students with irritable bowel syndrome symptoms. Gastroenterology Research and Practice. 2013;2013:1-8.Aim. To investigate the degree of mental strain and chronic stress in a German community sample of students with IBS-like symptoms. Methods and Materials. Following an internet-based survey about stress, this study recruited 176 German university students ( years; 48.3% males) with IBS-like symptoms according to Rome III and 181 students without IBS ( years; 50.3% males) and compared them regarding current mental strain (SCL-90-R) and the extend of chronic stress. Beyond this, IBS subtypes, IBS severity, and health care utilization were assessed. Results. Students fulfilling IBS criteria showed significantly elevated values of mental strain and chronic stress. Nearly 40% of the IBS group (versus 20% of the controls) reached a clinically relevant value on the SCL-90-R global severity scale. IBS subtypes did not differ in terms of mental distress or chronic stress. Somatization, anxiety, and the chronic stressors “work overload,” “social tension,” and “dissatisfaction with job” were most closely connected to IBS symptom severity. Regarding health care utilization, our results show that consulting a physician frequently was not associated significantly with elevated mental strain or chronic stress but with IBS symptom severity. Conclusion. Our data contribute additional evidence to the distinct association between psychological stress and IBS in community samples