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.
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