Abdominal Pain and anxiety—is there a link?

A Vanderbilt University study recently looked a little closer at a common childhood complaint—“my tummy hurts”—to see whether children with frequent functional abdominal pain (FAP) are more prone to anxiety disorders.

The study, published in August 2013, in the journal Pediatrics, tracked 332 children with FAP (abdominal pain without a medical cause) between the ages of 8 and 17, comparing them with 147 children reaching adulthood who had never had FAP.

The researchers caught up with the kids when they were around 20 to see if they had any symptoms of anxiety or depression.

A little more than half of the children who had FAP as children had an anxiety disorder at some time in their life. Thirty percent of those had a current anxiety disorder diagnosis when they were surveyed. And 40 percent of the children with FAP experienced depression as they were growing up, compared with 16 percent of those who had never experienced the abdominal pain.

“Anxious children are more likely to worry about pain and cautiously avoid activities—such as school—where they might have pain. This makes it more difficult for them to cope with pain and over time creates stress, such as getting behind in schoolwork, that can further exacerbate pain, anxiety and disability,” said study author Lynn Walker, Ph.D., professor of Pediatrics and Psychology.

A decade ago a well-publicized study determined that youth who presented with chronic stomach pain in primary care deserved careful assessment for anxiety and depressive disorders. But until the Vanderbilt study there has been no controlled prospective study that evaluated psychiatric outcomes for FAP patients in adulthood.

Social anxiety disorder was particularly common in the pediatric FAP patients. Patients with FAP carry a long-term vulnerability to anxiety that begins in childhood and persists into later adolescence and early adulthood, even if abdominal pain resolves, the study showed.