Psychiatric symptoms in children and adolescents with cyclic vomiting syndrome and their parents

Sally Tarbell, B U K Li
Headache 2008, 48 (2): 259-66

OBJECTIVE: To conduct a pilot study to evaluate the prevalence of psychiatric symptoms in children and adolescents with cyclic vomiting syndrome and to assess family history of psychiatric disorder.

BACKGROUND: Little is known about psychiatric comorbidity in youth with cyclic vomiting syndrome, a periodic syndrome.

METHODS: Eighty-five parents, of children aged 3-18 years with cyclic vomiting syndrome confirmed in a multidisciplinary clinic, completed the age-appropriate Children's Symptom Inventory, a questionnaire that screens for psychiatric symptoms in pediatric patients. Twenty-one adolescents aged 13-18 years completed the Youth's Report, a self-report form of this questionnaire. Sixty-two parents completed a family psychiatric history checklist.

RESULTS: These children and their parents evidenced a high prevalence of anxiety and mood symptoms compared to norms of the Children's Symptom Inventory and population norms for internalizing psychiatric disorders. On the age-appropriate Children's Symptom Inventory, 47% of subjects (40/85) met diagnostic cut-off for an anxiety disorder, and 14% (12/85) for an affective disorder. Discrepancies were found in parent and adolescent reports for symptoms of panic disorder (chi-square = 4.83, df = 1, P = .028), posttraumatic stress disorder (chi-square = 6.87, df = 1, P = .009), and somatization disorder (chi-square = 6.41, df = 1, P = .01), with parents reporting significantly more symptoms than the adolescents. Internalizing disorders were also prevalent in the parents with 59% (36/62) endorsing either an anxiety and/or an affective disorder. Mothers reported a significantly higher prevalence of anxiety disorders (35%) than did fathers (13%) (chi-square = 8.43, df = 1, P < .004).

CONCLUSION: Children and adolescents with cyclic vomiting syndrome appear to be at increased risk for internalizing psychiatric disorders, especially anxiety disorders. Further research using standardized psychiatric interviews and a control group are indicated to further assess psychiatric disorders in children and adolescents with cyclic vomiting syndrome.

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