Psychosocial Issues in Pediatric Inflammatory Bowel Disease: A Clinical Report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.

*Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH †Department of Psychology, RosalindFranklinUniversity of Medicine and Science, North Chicago, IL ‡Division of Pediatric Gastroenterology, University of Pittsburgh, Pittsburgh, PA §Division of Developmental & Behavioral Sciences/Division of Gastroenterology, Children's MercyHospitals and Clinics, Kansas City, MO ||University of Hartford, Hartford, CT ¶Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's HospitalMedical Center, Cincinnati, OH.
Journal of pediatric gastroenterology and nutrition (Impact Factor: 2.63). 04/2013; 56(4). DOI: 10.1097/MPG.0b013e3182841263
Source: PubMed


Pediatric inflammatory bowel disease(IBD) can affect many areas of psychosocial functioning, and comprehensive medical care includes consideration of psychosocial issues as well as disease factors. The purpose of this clinical report is to review research on psychosocial functioning in pediatric IBD and to provide recommendations for care providers in the areas of psychopathology, health related quality of life and social, family and school functioning. Youth with IBD are at increased risk for difficulty in all areas reviewed, and many psychosocial factors are associated with disease activity, which highlights the importance of monitoring psychosocial functioning as part of clinical care. Several interventions have empirical support or show promise for addressing psychosocial difficulty, and recommendations for monitoring and treating these issues are provided.

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Available from: Eva Szigethy, Dec 17, 2014
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    • "IBD is typically diagnosed in late adolescence or early adulthood and often leads to an impairment of the quality of life [3,4]. Adolescents may suffer from emotional and social problems and have impaired competence compared to their peers [5,6]. Active IBD may also impair cognitive functions [7]. "
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    ABSTRACT: The use of complementary alternative medicine (CAM) is potentially prevalent among paediatric patients with chronic diseases but with variable rates among different age groups, diseases and countries. There are no recent reports on CAM use among paediatric patients with inflammatory bowel disease (IBD) and juvenile idiopathic arthritis (JIA) in Europe. We hypothesized that CAM use associates with a more severe disease in paediatric IBD and JIA. A cross-sectional questionnaire study among adolescent outpatients with IBD and JIA addressing the frequency and type of CAM use during the past year. The patients were recruited at the Children's Hospital, University of Helsinki, Finland. Of the 147 respondents, 97 had IBD (Crohn's disease: n = 46; median age 15.5, disease duration 3.4 years) and 50 had JIA (median age 13.8, disease duration 6.9 years). During the past 12 months, 48% regularly used CAM while 81% reported occasional CAM use. Compared to patients with JIA, the use of CAM in IBD patients tended to be more frequent. The most commonly used CAM included probiotics, multivitamins, and mineral and trace element supplements. Self-imposed dietary restrictions were common, involving 27.6% of the non-CAM users but 64.8% of all CAM users. Disease activity was associated with CAM use in JIA but not in IBD. CAM use is frequent among adolescents with IBD and JIA and associates with self-imposed dietary restrictions. Reassuringly, adherence to disease modifying drugs is good in young CAM users. In JIA, patients with active disease used more frequently CAM than patients with inactive disease. As CAM use is frequent, physicians should familiarise themselves with the basic concepts of CAM. The potential pharmacological interaction or the toxicity of certain CAM products warrants awareness and hence physicians should actively ask their patients about CAM use.
    BMC Complementary and Alternative Medicine 04/2014; 14(1):124. DOI:10.1186/1472-6882-14-124 · 2.02 Impact Factor
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    • "Extradigestive manifestations may also occur [34]. IBD has been associated with significant personal and societal costs, including depression, anxiety, social deficits, self-management difficulties, poor school functioning, decreased health-related quality of life, and increased health care expenditures [35] [36] [37] [38] [39] [40]. The presentation of IBD is frequently variable, marked by symptom flares as well as extended quiescent periods in which few symptoms occur or in which pain behaviors may be infrequent or absent. "
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    ABSTRACT: This study sought to model and test the role of parental catastrophizing in relationship to parent-reported child pain behavior and parental protective (solicitous) responses to child pain in a sample of children with Inflammatory Bowel Disease and their parents (n = 184 dyads). Parents completed measures designed to assess cognitions about and responses to their child's abdominal pain. They also rated their child's pain behavior. Mediation analyses were performed using regression-based techniques and bootstrapping. Results supported a model treating parent-reported child pain behavior as the predictor, parental catastrophizing as the mediator, and parental protective responses as the outcome. Parent-reported child pain behavior predicted parental protective responses and this association was mediated by parental catastrophizing about child pain: indirect effect (SE) = 2.08 (0.56); 95% CI = 1.09, 3.30. The proportion of the total effect mediated was 68%. Findings suggest that interventions designed to modify maladaptive parental responses to children's pain behaviors should assess, as well as target, parental catastrophizing cognitions about their child's pain.
    Pain Research and Treatment 01/2014; 2014(8):751097. DOI:10.1155/2014/751097

  • Gastroenterology and Hepatology 03/2013; 9(3):189-91.
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