Abdominal pain in children: the role of possible psychosocial disorders, Spatuzzo et al, 2021

[Andy]

OBJECTIVE: To evaluate the relationship between functional abdominal pain and biopsychosocial factors: the current diagnostic criteria show limits.

PATIENTS AND METHODS: This is a retrospective cohort study conducted in paediatric emergency department (ED) of a tertiary hospital in Rome. Children (0-18 years) evaluated for abdominal pain in the paediatric ED between January 2018 and December 2018 were enrolled. Patients were divided in 2 groups: organic and functional groups. The main outcome was the prevalence of different subtypes of functional disorders (according to Rome IV criteria) and the role of possible biopsychosocial disorders related to patients with functional symptoms.

RESULTS: In this study, 1130 patients were included. In the functional group, 37.6% of patients were classified as affected by functional dyspepsia, 26.7% by functional abdominal pain-non otherwise specified (FAP-nos), 20.8% by inflammatory bowel syndrome (IBS), and 15.9% by abdominal migraine. Children of our functional sample reported at least one of the items present in the inventory CSSI-24 (24-item Children’s Somatic Symptoms Inventory), but more than 50% reported at least 4 of the items investigated.

CONCLUSIONS: At 6 and 12 months follow up and, new prospective studies on these disorders could improve the inclusion criteria for FGIDs, thinning the dubious rate of patients expected from the literature on the Rome IV criteria.

Open access, https://www.europeanreview.org/article/25097

 

[Arnie Pye]

So this paper, if I understood it correctly, was studying abdominal pain in children and were specifically sorting patients into organic and functional groups, and then following up the functional group. There isn't a single mention of "We diagnosed X children with a functional disorder but it turned out that they had an organic cause after all." The idea that diagnosing functional disorder in anyone of any age is never wrong is absurd.

I'm feeling particularly mentally and cognitively challenged today, so I could have missed what I was looking for. Apologies if that is the case.

 

[rvallee]

It's especially insulting to be denied research funding when you look at how much funding is wasted on trivial nonsense. This is basically a very expensive card-sorting thing where the outcome is rated based on whether the cards were sorted in the expected way.

The criteria separating the two are pretty much arbitrary, depending on how easy it is to see anything abnormal. Reminds me of how some physicians have no trouble taking identical patients with Long Covid and diagnosing one with LC and another with somatization disorder based on nothing but a positive test. Completely arbitrary process.

 

[Mithriel]

Abdominal migraine is only functional if you have already decided that migraine is a functional disorder. This paper is meaningless. It seems to be saying we sorted these kids according to our criteria and discovered that our criteria fit the way they were sorted. If there is anything else it eludes me.