Clinical masks of somato-forms disorders in view of disorders from the gastrointestinal tract and urinary systems associated with affective states in children
The aim of this study is to investigate the features of clinical manifestations of somatoform disorders (SD) from the side of gastrointestinal tract (GIT) and urinary system (US) and their relationship with affective conditions in children. We examined 123 children with SD from the side of gastrointestinal tract and 52 children with SD from the side of the urinary system. The average age of children was 13.6±2.2 years (M±σ), of which boys were 33.2% (n=58) and girls were 66.8% (n=117). It was used the Spielberger test to investigate anxiety. The Child Depression Questionnaire M. Kovacs (1992) was used to diagnose depression. The probability was evaluated using the Student’s t-test. Functional dyspepsia (FD) occupies the first place with 60.1%, irritable bowel syndrome (IBS) with second place (20.3%), functional diarrhea in 3.25% and functional constipation in 16.2%. Elderly children are 1.7 times more likely to suffer from IBS. IBS with constipation was found 3.8 times more frequent than diarrheal type. The diarrheal type of IBS is 5.1 times more common in boys than in girls. FD was more common in girls — 2.7 times with prevalence in children aged 10–14 years. In 31.7% of children with SD from the part of the gastrointestinal tract was found depression and in 84.6% of children there is clinically expressed anxiety. Among the children with SD, the number of young adolescents was 69.2%. The hyperreflective form of the bladder was found in 34.6%, the hyperreflex — in 26.9% of children. Enuresis occurred in 38.5% of children. 38.4% of children were diagnosed with depression and 88.5% expressed anxiety in patients with US. Depressive disorders as well as anxiety disorders can be one of the key factors in the occurrence of SD in children and manifest themselves in a variety of somatic masks in the form of functional disorders of organs and systems complicating the diagnosis, disease course and effectiveness of treatment. There was significant prevalence of anxiety (2:1 and 1.8:1, respectively) and depressive (3.3:1 and 4:1, respectively) disorders in women on both the GIT and US. Accordingly, female gender can be considered one of the main risk factors for the development of SD and emotional disorders in children.
2. Budnik, T. V. (2019). Vazhlyvist korektsii vehetatyvnoi dysfunktsii u ditei iz rozladamy sechovypuskannia, abo yak pidvyshchyty efektyvnist terapii hiperaktyvnoho sechovoho mikhura [The importance of correction of autonomic dysfunction in children with urinary disorders or How to improve the efficacy of neurogenic bladder therapy]. Zdorov’e rebenka – Child’s health, 14 (1), 2–7. doi: 10.22141/2224-05184.108.40.2069.157875.
3. Grigorenko, A. P. (2009). Osobennosti diagnostiki vegetativnoj disfunkczii u shkol`nikov i studentov mladshikh kursov [Features of vegetative dysfunction diagnostics in schoolchildren and first-years students]. Nauchnye vedomosti Belgorod. gos. un-ta. Ser. Medicina. Farmaciya – Scientific reports Belgorod. state un-ty. Ser. Medicine. Pharmacy, 12 (67), 31–36. Vzyato s https://cyberleninka.ru/article/n/osobennosti-diagnostiki-vegetativnoy-disfunktsii-u-shkolnikov-i-studentov-mladshih-kursov/viewer.
4. Zviahintseva, T. D., & Hridnieva, S. V. (2016). Syndrom podraznenoho kyshechnyka: suchasni aspekty patohenezu i taktyka likuvannia [Irritable bowel syndrome: current aspects of pathogenesis and treatment tactics]. Suchasna hastroenterolohiia – Modern gastroenterology, 5 (91), 88–94.
5. Iskakova, U. B., Abisheva, Z. S., Zhurunova, M. S., Zhetpisbaeva, G. D., & Ismagulova, T. M. (2016). Situativnaya trevozhnost' i psiho-emocional'noe sostoyanie studentov vo vremya rubezhnogo kontrolya [Situational anxiety and psycho-emotional state of the students during the boundary control]. Mezhdunarodnyy zhurnal prikladnyh i fundamental'nyh issledovaniy - International journal of applied and fundamental research, 11 (5), 900–902. Vzyato s https://applied-research.ru/ru/article/view?id=10555.
6. Maidannyk V. H. (2016). Rymski kryterii IV (2016): shcho novoho? [Rome IV (2016) criteria: What is new?]. Mizhnarodnyi zhurnal pediatrii, akusherstva ta hinekolohii – International Journal of Pediatrics, Obstetrics and Gynecology, 10 (1), 8–18. Vzyato z http://ijpog.org/downloads/24/8-18.pdf.
7. Maidannyk, V. H., Mitiuriaieva-Korniiko, I. O., Kukhta, N. M., & Hnyloskurenko, H. V. (2017). Vehetatyvni dysfunktsii u ditei. Paroksyzmalna vehetatyvna nedostatnist [Vegetative dysfunction in children. Paroxysmal vegetative insufficiency]. Kyiv: Lohos.
8. Morozov, S. L. (2013). Sovremenny`e predstavleniya o nejrogennoj disfunkczii mochevogo puzy`rya [Current concepts of neurogenic bladder dysfunction]. Ros. vestn. perinatol. i pediatr. – Russian bulletin of perinatology and pediatry, 4, 24–29.
9. Mostova, O. P. (2017). Alhorytmy vyiavlennia i orhanizatsii dopomohy pry rozladakh psykhiky i povedinky u ditei [Algorithms for identifying and organizing help in mental and behavioral disorders in children]. Mizhnarodnyi zhurnal pediatrii, akusherstva i hinekolohi – International Journal of Pediatrics, Obstetrics and Gynecology, 11 (3), 44.
10. Pavlovskyi, L. L. (2017). Rymskye kryteryy IV: osobennosty dyahnostyky, klynyky y lechenyia syndroma razdrazhennoho kyshechnyka [Roman Criteria IV: Features of Diagnosis, Clinic, and Treatment of Irritable Bowel Syndrome]. Medychna hazeta “Zdorovia Ukrainy 21 storichchia” – 21st Century Health Ukraine Health Newspaper, 7 (404), 18–19.
11. Sirchak, Ye. S. (2016). Funktsionalna dyspepsiia u pryzmi Rymskykh kryteriiv IV [Functional dyspepsia in the prism of Roman criteria IV]. Medychna hazeta “Zdorovia Ukrainy 21 storichchia”. Tematychnyi nomer “Hastroenterolohiia, hepatolohiia, koloproktolohiia” – “Health newspaper 21st Century Ukraine” Thematic Issue “Gastroenterology, Hepatology, Coloproctology”, 3 (41), 5–6..
12. Tereshhenko, S. Yu., Lapteva, L. V., Gorbacheva, N. N., & Vasil`eva, L. V. (2014). Komorbidnost` reczidiviruyushhikh bolej v zhivote u podrostkov [Comorbidity of recurrent abdominal pain in adolescents]. Rossijskij zhurnal boli – Russian Journal of Pain, 1 (42), 94–95. Vzyato s https://elibrary.ru/item.asp?id=23863087.
13. Drossman, D. A., & Hasler, W. L. (2016). Rome IV — Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology, 150 (6), 1257–1261. doi: 10.1053/j.gastro.2016.03.035.
14. Garcia-Martin, I. E., Miranda-Vicario, M., & Soutullo, C. A. (2012). Duloxetine in the treatment of adolescents with somatoform disorders: a report of two cases. Actas Esp. Psiquiatr., 40 (3), 165–168. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22723136.
15. Heimann, P., Herpertz-Dahlmann, B., Buning, J., Wagner, N., Stollbrink-Peschgens, C., Dempfle, A., & von Polier, G. G. (2018). Somatic symptom and related disorders in children and adolescents: evaluation of a naturalistic inpatient multidisciplinary treatment. Child Adolesc Psychiatry Ment Health, 12, 34. doi: 10.1186/s13034-018-0239-y.
16. Silber, T. J. (2011). Somatization Disorders: Diagnosis, Treatment, and Prognosis. Pediatr. Rev., 32 (2), 56–64. doi: 10.1542/pir.32-2-56.
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