Relationship between the decision to take a child to the clinic for abdominal pain and maternal psychological distress

Background: Among adults with functional gastrointestinal disorders, psychological distress influences who consults a physician, but little is known about predictors of consultation when the patient is a child. Objective: To determine the relative contributions of psychological symptoms of the mother, psychological symptoms of the child, severity of child abdominal pain, and family stress to consultation. Design: Observational study. Setting: Health maintenance organization. Participants: Two hundred seventy-five mothers of 334 children who had abdominal pain in the past 2 weeks, as per child self-report. Main Outcome Measures: Mothers completed questionnaires about themselves (Symptom Checklist 90-Revised) and their children (school absences, medication use, and the Child Behavior Checklist). Children completed the Pain Beliefs Questionnaire to assess perceived pain severity. Results: Thirty-nine children had been taken to the clinic for abdominal pain symptoms at least once in the past 3 months (consulters), whereas 295 were nonconsulters. Logistic regression analyses revealed that both the child's self-report of perceived pain severity (P<.001) and maternal psychological symptoms (P=.006) predicted consultation. Although children who visited physicians had significantly more psychological symptoms, this was not a significant predictor of consultation after adjusting for maternal psychological symptoms. Family stress did not predict consultation. Conclusion: The decision to take a child to the clinic for abdominal pain is best predicted by maternal psychological distress and the child's perceived pain severity.